J Korean Med Sci.  2008 Jun;23(3):378-382. 10.3346/jkms.2008.23.3.378.

Surgical Management of Mechanical Valve Thrombosis: Twenty-Six Years' Experience

• Ahn H
• Kim KH
• Kim KC
• Kim CY

• KMID: 1786872
• DOI: http://doi.org/10.3346/jkms.2008.23.3.378

Abstract

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.

Keyword

Mechanical Valve; Thrombosis; Heart Valves

MeSH Terms

Adult
Aged
Anticoagulants/therapeutic use
Coronary Thrombosis/drug therapy/*mortality/*surgery
Drug Interactions
Female
Follow-Up Studies
Heart Valve Prosthesis/*adverse effects/*statistics & numerical data
Heparin/therapeutic use
Humans
International Normalized Ratio
Male
Middle Aged
Patient Compliance
Postoperative Complications/drug therapy/*mortality/*surgery
Pregnancy
Pregnancy Complications/mortality
Recurrence
Reoperation/statistics & numerical data
Retrospective Studies
Risk Factors
Thrombolytic Therapy
Warfarin/therapeutic use

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