Mechanical prosthetic valve thrombosis in current era: 5-year follow-up

Abstract

Introduction: The incidence of prosthetic valve dysfunction (stuck valve) is variable and is dependent on various factors. There are studies from Indian groups that have emphasized the success of thrombolysis; however, none of them reported a follow-up. This study was designed to emphasize on the follow-up of these patients at midterm.

Material and methods: The patients of prosthetic valve thrombosis between period of January 2013 and December 2017 were included in this retrospective observational study. Sixty-six patients were admitted with stuck valve during this period. Thrombolysis was preferred modality of treatment. Survivors were followed up with serial echocardiography, which included estimation of left ventricular and valve functions.

Results: Of a total of 66 patients, 59 were of stuck mitral valve and 7 stuck aortic valve. The event happened at a mean of 48.86 ± 48.80 months after index operation of valve replacement using mechanical valve prosthesis. The median age was 40.27 ± 10.8 years with 39 males and 27 females. Thrombolysis was successful in 61 patients with a mortality of 5 (7.57%). During a mean follow-up of 22.7 ± 20.9 months, 42 patients were alive with 14 (22.95%) patients dead and 5 patients lost to follow-up. The average follow-up was 18.7 ± 22.7 months before death.

Conclusion: Following good early results after thrombolysis, patients of prosthetic heart valve thrombosis experience high mortality within 2 years of follow-up. These patients require frequent follow-up to avoid early mortality.

Keywords: Follow-up after valve thrombosis; Prosthetic valve thrombosis; Thrombolysis.

Fig. 1

Development of prosthetic valve thrombosis in months since the time of operation

Fig. 2

Survival curve of mortality after successful thrombolysis of prosthetic valve thrombosis during follow-up in months