Prosthetic Valve Thrombosis: Diagnosis and Management

Jalaj Garg, Chandrasekar Palaniswamy, Sowmya Pinnamaneni, Judy Sarungbam, Diwakar Jain

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

St. Jude mechanical prosthesis is the most commonly used prosthetic device with least valvular complications with excellent hemodynamics. However, prosthetic valve thrombosis is one of the serious complications, with rates between 0.03% and 0.13% per patient-year depending on the type of anticoagulation used and compliance to the therapy. Transthoracic echocardiography (TTE) is the initial screening tool (class I) that would provide clues for the assessment of valvular hemodynamics. Fluoroscopy is an alternate imaging modality for the assessment of mechanical leaflet motion, especially in patients when prosthetic valves are difficult to image on TTE or transesophageal echocardiography. A complete fluoroscopic evaluation of a prosthetic valve includes assessment of valvular motion and structural integrity. Opening and closing angles can be measured fluoroscopically to determine whether a specific valve is functioning properly. We discuss a case of a 91-year-old man with thrombosis of bileaflet mechanical mitral prosthesis that was demonstrated on real-time fluoroscopy (not evident on TTE). An algorithmic approach to diagnosis and management of prosthetic heart valve thrombosis is outlined.

Original languageEnglish (US)
Pages (from-to)e252-e255
JournalAmerican journal of therapeutics
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • fluoroscopy
  • mitral valve thrombosis
  • prosthetic valve thrombosis

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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    Garg, J., Palaniswamy, C., Pinnamaneni, S., Sarungbam, J., & Jain, D. (2016). Prosthetic Valve Thrombosis: Diagnosis and Management. American journal of therapeutics, 23(1), e252-e255. https://doi.org/10.1097/MJT.0000000000000117