Surgical management of mechanical valve thrombosis: twenty-six years' experience.
In the present study, the authors investigated the management of mechanical valve thrombosis (MVT). From January 1981 through March 2006, 2,908 mechanical valve replacements were performed in 2,298 patients at our institution. Twenty (0.87%) patients presented with MVT, 14 (70.0%) were women, and the mean age of the patients was 42.0+/-14.0 (27-66) yr. Thrombosis involved mitral in 14 (70.0%), aortic in 2 (10.0%), tricuspid/aortic in 1 (5%), and tricuspid in 3 (15%). The interval from first operation to valve thrombosis was 121.8+/-75.4 (0.9-284.7) months. The most frequent clinical presentation was heart failure (13/20, 65%), and predisposing causes of MVT were: poor compliance with warfarin (7), pregnancy (5), drug interaction (2), and unknown (6). All 20 patients underwent valve replacement: mitral (14, 70.0%), tricuspid (3, 15.0%), aortic (2, 10%) and tricuspid/aortic (1, 5%). One early death occurred due to left ventricular failure, but no late mortality occurred during 63.3+/-49.9 (0.5-165.1) months of follow-up. MVT was treated successfully, and pregnancy and inadequate anticoagulation were found to influence the occurrence of this rare complication.
Ahn
Hyuk
H
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea.
Kim
Kyung-Hwan
KH
Kim
Kwan Chang
KC
Kim
Chang Young
CY
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D003328:Coronary Thrombosis / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery*; D004347:Drug Interactions; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects* / Q000706:statistics & numerical data*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011183:Postoperative Complications / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D015912:Thrombolytic Therapy; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin