Mechanical prosthetic valve thrombosis in current era: 5-year follow-up
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ORIGINAL ARTICLE
Mechanical prosthetic valve thrombosis in current era: 5-year follow-up Supaksh Mahindru 1 & Shantanu Pande 1 & Pulkit Malhotra 1 & Ankit Thukral 1 & Ankush Singh Kotwal 1 & Rajan Prasad Gupta 1 & Naveen Garg 2 & Aditya Kapoor 2 & Surendra Kumar Agarwal 1 Received: 13 January 2020 / Revised: 20 August 2020 / Accepted: 24 August 2020 # Indian Association of Cardiovascular-Thoracic Surgeons 2020
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 Prosthetic valve thrombosis . Thrombolysis . Follow-up after valve thrombosis
Introduction Valve disease in India has been predominantly a consequence of rheumatic heart disease [1, 2]. This leaves a young population of patients, affected by rheumatic heart valve disease, with the option of replacement of heart valves [3]. Replacement of valve at a young age merits a mechanical heart valve prosthesis [4]. A bioprosthetic valve as a choice for replacement has been associated with accelerated degeneration of the valve and requirement of frequent rereplacement [5]. While replacement with prosthetic valve * Shantanu Pande [email protected]; [email protected] 1
Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
2
Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
may not be advisable, repair of the rheumatic valve, though an option, may not last long, warranting a reoperation [6]. Following mechanical valve replacement anticoagulation with vitamin K ant
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