title: [Thrombosis of heart valve prostheses: favourable and prognostic factors based on a study of 41 patients].
abstract: Forty one patients were admitted with a diagnosis of prosthetic valve thrombosis. One patient was thrombolysed successfully, and 40 underwent surgical procedures. In 13 cases, prosthetic valve thrombosis occurred in the first month after valve replacement. 18 patients were in functional class IV of the NYHA classification. Among the thrombosed prostheses, 91% were mechanical, and 61% in mitral position. Adequacy of anti-coagulation was the most important risk factor, as this treatment was inappropriate in 20 patients. In 10 other patients, it had been changed for medical (bleeding events, pregnancy) or surgical (non cardiac surgery) reasons. The perioperative mortality rate was high (32.4%). It was 12% in patients in functional class II and 46% in those in class IV (p < 0.05). This underlines the value of early diagnosis, in which echocardiography, especially with a transesophageal probe, takes a major place, allowing prompt surgical treatment.
authors.affiliation: Service d'Anesthésie-Réanimation, Hôpital Bichat, Paris.
authors.forename: R
authors.initials: R
authors.lastname: Mustapha
authors.forename: I
authors.initials: I
authors.lastname: Philip
authors.forename: G
authors.initials: G
authors.lastname: Bohm
authors.forename: J P
authors.initials: JP
authors.lastname: Depoix
authors.forename: D
authors.initials: D
authors.lastname: Enguerand
authors.forename: M
authors.initials: M
authors.lastname: Debauchez
authors.forename: U
authors.initials: U
authors.lastname: Hvass
authors.forename: Y
authors.initials: Y
authors.lastname: Pansard
authors.forename: J M
authors.initials: JM
authors.lastname: Desmonts
authors.forename: J
authors.initials: J
authors.lastname: Langlois
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001021:Aortic Valve / Q000601:surgery; D002675:Child, Preschool; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011379:Prognosis; D012086:Reoperation; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D014261:Tricuspid Valve / Q000601:surgery; D014463:Ultrasonography
chemical_list: D000925:Anticoagulants
vernacular_title: Thromboses de prothèses valvulaires cardiaques: facteurs favorisants et pronostiques à partir d'une étude portant sur 41 patients.