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Prosthetic Heart Valve Thrombosis

(Prosthetic Valve Thrombosis; PVT)
  • Definition

    Prosthetic heart valve thrombosis is a rare, but serious complication of a heart valve replacement procedure. The complication occurs when a blood clot called a thrombus is attached to or near a prosthetic heart valve. This can obstruct blood flow or interfere with the function of the valve.
    Prosthetic heart valve thrombosis is a medical emergency.
    Heart Valves With Prosthetic Replacements
    BP00039 97870 1 heart valve.jpg
    Copyright © Nucleus Medical Media, Inc.
  • Causes

    Prosthetic heart valve thrombosis is thought to result from an interaction between components of blood and the prosthesis or blood flow in and around the prosthesis.
  • Risk Factors

    Factors that may increase your chance of prosthetic heart valve thrombosis include:
    • Inadequate anticoagulant/blood thinning therapy after a valve transplant
    • Prosthesis located at the mitral valve in the heart
    • Atrial fibrillation
    • Medications, such as contraceptives
    • Cancerous tumors
    • Systemic diseases such as systemic lupus erythematosus, or inflammation and damage to various body tissues, including joints, skin, kidneys, heart, lungs, blood vessels, and brain
    • Reduced cardiac pumping—possibly from heart failure
  • Symptoms

    Prosthetic heart valve thrombosis may cause:
    • Shortness of breath
    • Difficulty breathing while lying down
    • Swelling
    • Fatigue
    • Difficulty exercising
    • Chest pain, burning, or pressure
    • Nausea
    • Numbness
    • Loss of consciousness
  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam may be done.
    Images evaluate your heart and surrounding structures. These may include:
    Your bodily fluids may need to be tested. This can be done with blood tests.
  • Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include:
    Thrombolysis
    The first line of therapy is usually thrombolysis, which are medications that break up abnormal blood clots.
    Anticoagulation Therapy
    Anticoagulant medications are used to control clotting. Anticoagulation therapy may be used alone in people with small clots that are not obstructing the heart valve.
    Valve Replacement
    In some cases, surgery to replace the valve may be necessary.
  • Prevention

    In people who have prosthetic heart valves, antithrombotic therapy is the best proven way to reduce your chance of prosthetic heart valve thrombosis.
  • RESOURCES

    American Heart Association http://www.heart.org

    National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov

    CANADIAN RESOURCES

    Canadian Heart Research Centre http://www.chrc.net

    Heart and Stroke Foundation of Canada http://www.heartandstroke.ca

    References

    Prosthetic heart valve dysfunction. DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 19, 2014. Accessed September 26, 2014.

    Serpi M, Schmidt KG, Kreuz W, et al. Thrombolysis of prosthetic heart valve thrombosis using recombinant tissue plasminogen activator (rt-PA) in infancy and childhood. Z Kardiol. 2001;90(3):191-196.

    Roudant R, Serri K, Lafitte S. Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations. Heart. 2007;93:137-142.

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