title: Treatment of obstructive thrombosed prosthetic heart valve.
abstract: Obstructive thrombosed prosthetic heart valve (OTPHV) is a serious complication of heart valve replacement. There are no generally accepted criteria for management of these patients. Therefore, in September 2012, a literature survey of studies published after 1995 was performed to analyze the data regarding clinical outcomes of patients with OTPHV treated with thrombolytic agents and with surgery since 1996. The search yielded appropriate and relevant studies, which included 17 studies comprising 756 patients who had received thrombolytic therapy and 13 studies comprising 662 patients who had received surgery. The data on these 2 groups was analyzed in detail relating to frequency of use of the diagnostic studies, baseline patient data, and on the rate of complete success, outcomes, and complications of the therapy they had received, and the limitations of the studies. We have then developed a strategy for therapy of OTPHV.
authors.affiliation: Griffith Center, Division of Cardiovascular Medicine, Department of Medicine, LAC + USC Medical Center, Keck School of Medicine at University of Southern California, Los Angeles, California.
authors.forename: Grace
authors.initials: G
authors.lastname: Huang
authors.forename: Hartzell V
authors.initials: HV
authors.lastname: Schaff
authors.forename: Thoralf M
authors.initials: TM
authors.lastname: Sundt
authors.forename: Shahbudin H
authors.initials: SH
authors.lastname: Rahimtoola
mesh_terms: D017548:Echocardiography, Transesophageal; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008943:Mitral Valve; D011475:Prosthesis Failure; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology
chemical_list: D005343:Fibrinolytic Agents
keywords: CVA; NYHA; New York Heart Association; OTPHV; PHV; TEE; TTE; cardiovascular accident(s); obstructive thrombosed prosthetic heart valve; obstructive valve thrombosis; prosthetic heart valve; prosthetic heart valve thrombosis; transesophageal echocardiography; transthoracic echocardiography; valve thrombosis