A Successful Case of Repeat Thrombolysis in Acute Prosthetic Valve Thrombosis

2010 ◽  
Vol 9 (2) ◽  
pp. 73-75
Author(s):  
Shairana Naleem ◽  
◽  
Muhammad Abdulmajid Patel ◽  
Sandeep Basavarajaiah ◽  
Rajesh Aggarwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Prosthetic Valve ◽  
Heart Valves ◽  
Therapeutic Modalities ◽  
Prosthetic Valve Thrombosis ◽  
Acute Medical Unit ◽  
Successful Case ◽  
Valve Thrombosis ◽  
Prosthetic Mitral Valve

Acute heart failure is an important presentation in the Acute Medical Unit. We describe a case of successful repeat thrombolysis in an elderly woman presenting as an emergency with severe pulmonary oedema, due to acute prosthetic mitral valve thrombosis. The diagnostic imaging and therapeutic modalities available are also described.This case highlights the need for acute physicians to consider prosthetic valve thrombosis in the differential for patients with metallic heart valves who present with acute heart failure or cardiogenic shock.

Conservative Management of a Prosthetic Valve Thrombosis – Report of a Successful Case

2014 ◽  
Vol 23 (10) ◽  
pp. e207-e209 ◽  
Author(s):  
Carla Sousa ◽  
Jorge Almeida ◽  
Paula Dias ◽  
Pedro Almeida ◽  
Inês Rangel ◽  
...  
Keyword(s):  
Conservative Management ◽  
Prosthetic Valve ◽  
Prosthetic Valve Thrombosis ◽  
Successful Case ◽  
Valve Thrombosis

scholarly journals Successful Fibrinolytic Therapy in a Challenging Obstructive Prosthetic Mitral Valve Thrombosis

2020 ◽  
Vol 8 ◽  
pp. 232470962092107
Author(s):  
Amr Essa ◽  
Toufik Haddad ◽  
Terrence Slattery
Keyword(s):  
Mitral Valve ◽  
Prosthetic Valve ◽  
Multimodality Imaging ◽  
Fibrinolytic Therapy ◽  
Mitral Valve Surgery ◽  
Prosthetic Valve Thrombosis ◽  
Valve Thrombosis ◽  
Mean Pressure ◽  
Normal Mean ◽  
Prosthetic Mitral Valve

Prosthetic valve thrombosis is a rare and severe complication of the mechanical prosthetic valve. Management can be challenging due to varying clinical presentation, overlapping features of differential diagnosis, and lack of randomized controlled trials on the therapeutic options. In this article, we report the case of a patient with a mechanical prosthetic mitral valve presented with symptoms of heart failure, and an echocardiography showing increased mean pressure gradient across the prosthesis along with a fixed posterior leaflet and a partially restricted anterior leaflet with no visible mass. That raised the concern for an obstructed prosthesis. After multimodality imaging and multidisciplinary team discussions, prosthetic valve thrombosis diagnosis was favored over other different diagnoses that included but not limited to pannus ingrowth. Fibrinolytic therapy was administrated, and the patient was discharged on optimal anticoagulation. Repeated echocardiography a month later showed normal mean gradient and normal functioning prosthetic mitral valve without the need for repeat mitral valve surgery.

scholarly journals Severe Vascular Complications Following Thrombolytic Therapy in a Case of Prosthetic Mitral Valve Thrombosis – A Case Report

2021 ◽  
Vol 10 (14) ◽  
pp. 1035-1038
Author(s):  
Ayan Husain ◽  
Shilpa Abhay Gaidhane ◽  
Priti Abhay Karadbhajane ◽  
Sourya Acharya ◽  
Apoorva Nirmal
Keyword(s):  
Thrombolytic Therapy ◽  
Prosthetic Valve ◽  
Prosthetic Heart Valve ◽  
Vascular Complications ◽  
Mechanical Valve ◽  
Fibrinolytic Therapy ◽  
Prosthetic Valve Thrombosis ◽  
Valve Thrombosis ◽  
Prosthetic Mitral Valve ◽  
Immediate Surgery

Prosthetic cardiac valve thrombosis is a rare but dangerous complication; 1,2 particularly in patients with low conformity on anticoagulant therapy. Thromboembolic problems happen after mechanical valve substitution in 0.5 - 8 percent. 3-5 Fibrinolytic therapy to treat the thrombosis is widely used nowadays with high efficacy and no severe side effects as compared to emergency surgical treatment, which is associated with high mortality.6 Surgical valve repair in patients with rheumatic heart disease remains the gold standard for the treatment. Thrombosis of the prosthetic heart valve in patients undergoing valve replacement, is the most severe and deadly complication. Currently, the treatments available for symptomatic prosthetic valve thrombosis are immediate surgery or thrombolytic therapy (TT). In rural hospital settings patients are poor and there is a lack of surgical expertise. These factors make TT the perfect treatment for prosthetic valve thrombosis. But one should be aware of embolic complications.

scholarly journals Maternal and Fetal Outcomes in Pregnant Women with a Prosthetic Mechanical Heart Valve

2016 ◽  
Vol 10 ◽  
pp. CMC.S36740 ◽  
Author(s):  
Sherif W. Ayad ◽  
Mahmoud M. Hassanein ◽  
Elsayed A. Mohamed ◽  
Ahmed M. Gohar
Keyword(s):  
Heart Failure ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
First Trimester ◽  
Fetal Outcomes ◽  
Prosthetic Valve Thrombosis ◽  
Daily Dose ◽  
Valve Thrombosis ◽  
Fetal Complications ◽  
Valve Prostheses

Background Pregnancy is associated with several cardiocirculatory changes that can significantly impact underlying cardiac disease. These changes include an increase in cardiac output, sodium, and water retention leading to blood volume expansion, and reductions in systemic vascular resistance and systemic blood pressure. In addition, pregnancy results in a hypercoagulable state that increases the risk of thromboembolic complications. Objectives The aim of this study is to assess the maternal and fetal outcomes of pregnant women with mechanical prosthetic heart valves (PHVs). Methods This is a prospective observational study that included 100 pregnant patients with cardiac mechanical valve prostheses on anticoagulant therapy. The main maternal outcomes included thromboembolic or hemorrhagic complications, prosthetic valve thrombosis, and acute decompensated heart failure. Fetal outcomes included miscarriage, fetal death, live birth, small-for-gestational age, and warfarin embryopathy. The relationship between the following were observed: – Maternal and fetal complications and the site of the replaced valve (mitral, aortic, or double) – Maternal and fetal complications and warfarin dosage (≤5 mg, >5 mg) – Maternal and fetal complications and the type of anticoagulation administered during the first trimester Results This study included 60 patients (60%) with mitral valve replacement (MVR), 22 patients (22%) with aortic valve replacement (AVR), and 18 patients (18%) with double valve replacement (DVR). A total of 65 patients (65%) received >5 mg of oral anticoagulant (warfarin), 33 patients (33%) received ≤5 mg of warfarin, and 2 patients (2%) received low-molecular-weight heparin (LMWH; enoxaparin sodium) throughout the pregnancy. A total of 17 patients (17%) received oral anticoagulant (warfarin) during the first trimester: 9 patients received a daily warfarin dose of >5 mg while the remaining 8 patients received a daily dose of ≤5 mg. Twenty-eight patients (28%) received subcutaneous (SC) heparin calcium and 53 patients (53%) received SC LMWH (enoxaparin sodium). Prosthetic valve thrombosis occurred more frequently in patients with MVR ( P = 0.008). Postpartum hemorrhage was more common in patients with aortic valve prostheses than in patients with mitral valve prostheses ( P 0.005). The incidence of perinatal death was higher in patients with AVR ( P 0.014). The incidence of live birth was higher in patients with DVR ( P 0.012). The incidence of postpartum hemorrhage was higher in patients who received a daily dose of >5 mg of warfarin than in patients who received ≤5 mg of warfarin ( P 0.05). The incidence of spontaneous abortion was also higher in patients receiving >5 mg of warfarin (P ≤ 0.001), while the incidence of live births was higher in patients receiving ≤5 mg of warfarin ( P 0.008). There was a statistically significant difference between the anticoagulant received during the first trimester and cardiac outcomes. Specifically, patients on heparin developed more heart failure ( P 0.008), arrhythmias ( P 0.008), and endocarditis ( P 0.016). There was a statistically significant relationship between heparin shifts during the first trimester and spontaneous abortion ( P 0.003). Conclusion Warfarin use during the first trimester is safer for the mother but is associated with more fetal loss, especially in doses that exceed 5 mg. The incidence of maternal complications is greater in women who receive LMWH or unfractionated heparin during the first trimester, especially prosthetic valve thrombosis, although the fetal outcome is better because heparin does not cross the placenta.

Transcatheter mechanical manipulation of obstructed prosthetic mitral valve in an infant

2020 ◽  
Vol 30 (11) ◽  
pp. 1747-1749
Author(s):  
Yousef Arar ◽  
Jeff Hong ◽  
Surendranath Veeram Reddy
Keyword(s):  
Mitral Valve ◽  
Prosthetic Valve ◽  
Transoesophageal Echocardiography ◽  
Pulmonary Haemorrhage ◽  
Treatment Modalities ◽  
Prosthetic Heart Valves ◽  
Systemic Thrombolysis ◽  
Prosthetic Valve Thrombosis ◽  
Valve Thrombosis ◽  
Prosthetic Mitral Valve

AbstractProsthetic valve thrombosis is a serious complication of prosthetic heart valves that typically requires either surgical intervention or systemic thrombolysis. In patients with contraindications to both treatment modalities, options can be limited. We describe an alternative approach to managing prosthetic valve thrombosis in an infant presenting in extremis with pulmonary haemorrhage. Using transoesophageal echocardiography and fluoroscopic guidance, we restored function to the infant’s obstructed St. Jude prosthetic mitral valve through percutaneous transcatheter manipulation of the valve’s leaflets.

scholarly journals Fibrinolytic Treatment after Transient Ischaemic Attack Caused by Prosthetic Mitral Valve Thrombosis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Cornel Koban ◽  
Michael Neuß ◽  
Grit Tambor ◽  
Frank Hölschermann ◽  
Christian Butter
Keyword(s):  
Mitral Valve ◽  
Complete Resolution ◽  
Prosthetic Valve ◽  
Prosthetic Valve Thrombosis ◽  
Echocardiographic Examination ◽  
Valve Thrombosis ◽  
Life Threatening ◽  
Ischaemic Attack ◽  
Prosthetic Mitral Valve ◽  
Surgical Valve Replacement

Prosthetic valve thrombosis is one of the most severe complications after surgical valve replacement. There are many possible presentations: from asymptomatic to life-threatening complications. We report on a 61-year-old female patient with prosthetic replacement of the aortic and mitral valve in the in-house department of cardiac surgery 3 months ago. The patient was suffering from aphasia during 5 minutes in domesticity. After her presentation in the emergency room, the echocardiographic examination revealed a thrombotic formation of the prosthetic mitral valve. At presentation, the anticoagulation was outside the effective range (INR: 1.7). A successful thrombolytic therapy with the plasminogen activator urokinase was begun with complete resolution of the thrombus.

scholarly journals Surgical treatment of a case of acute left heart failure caused by prosthetic valve thrombosis after mitral valve replacement

2021 ◽  
Author(s):  
pengying zhao ◽  
ruisheng liu ◽  
bing song
Keyword(s):  
Heart Failure ◽  
Surgical Treatment ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Prosthetic Heart Valve ◽  
Left Heart ◽  
Left Heart Failure ◽  
Prosthetic Valve Thrombosis ◽  
Valve Thrombosis

Prosthetic valve thrombosis ( PVT) is a serious complication after prosthetic heart valve replacement.When thrombosis causes the prosthetic valve to disfunction, it may cause the patient to die.We successfully treated a patient with acute left heart failure due to prosthetic valve thrombosis. The report is as follows.

scholarly journals Renal artery embolism following thombolytic therapy for prosthetic valve thrombosis

Heart Views ◽  
2011 ◽  
Vol 12 (2) ◽  
pp. 81
Author(s):  
Sudeep Kumar ◽  
Sunil Kumar ◽  
Nagaraja Moorthy ◽  
Aditya Kapoor
Keyword(s):  
Renal Artery ◽  
Prosthetic Valve ◽  
Prosthetic Valve Thrombosis ◽  
Artery Embolism ◽  
Valve Thrombosis
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