EDUCATION IN HEART

Valve disease

Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations

Raymond Roudaut, Karim Serri, Stephane Lafitte

Hôpital Cardiologique du Haut-Lévêque, Centre hospitalier et universitaire de Bordeaux, Université Victor Segalen, Bordeaux, France

Correspondence to:
Correspondence to:
Professor Raymond Roudaut
Service des Echocardiographies, Hôpital Cardiologique Haut-Leveque, Avenue Magellan, Pessac 33604, France; raymond.roudaut@pu.u-bordeaux2.fr

Keywords: prosthetic heart valves; prosthetic valve thrombosis

The first 150 words of the full text of this article appear below.

Prosthetic valve thrombosis (PVT) is a rare but serious complication of valve replacement, most often encountered with mechanical prostheses. The significant morbidity and mortality associated with this condition warrants rapid diagnostic evaluation. However, diagnosis can be challenging, mainly because of variable clinical presentations and the degree of valvular obstruction. Cinefluoroscopy (for mechanical valves) and transthoracic and transoesophageal echocardiography represent the main diagnostic procedures.

Although surgical treatment is usually preferred in cases of obstructive PVT, optimal treatment remains controversial. The different therapeutic modalities available for PVT (heparin treatment, fibrinolysis, surgery) will be largely influenced by the presence of valvular obstruction, by valve location (left- or right-sided), and by clinical status. Hence, treatment of an obstructive left-sided PVT will differ from that of non-obstructive or right-sided PVT. The purpose of this article is to review the physiopathology, diagnosis and treatment of PVT and to provide recommendations for management.

EPIDEMIOLOGY

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Prosthetic Heart Valve Thrombosis. Is thrombolysis really still controversial?

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Online, 20 Feb 2007 [Full text]