Surgical treatment of left-sided mechanical valve thrombosis:
Twelve years’ experience
DOI: https://doi.org/10.36811/jcshd.2022.110028 JCSHD: April-2022: Page No: 68-74
Page: 68
www.raftpubs.com
Journal of Cardiovascular Surgery and Heart Diseases
Research Article Open Access
Surgical treatment of left-sided mechanical valve thrombosis: Twelve
years’ experience
Sami Bouchenafa
*
, Ahmed Zaki Boukli Hacene, Boukri Hamouda and Mohammed Atbi
Cardiac Surgery Department, EHU Oran, Algeria
*Corresponding Author: Sami Bouchenafa, Cardiac Surgery Department, EHU Oran, Algeria, Tel:
+213555485074; Email: dr.bouchenafa@gmail.com; sami_bouchenafa@hotmail.fr
Received Date: Mar 31, 2022 / Accepted Date: Apr 19, 2022/ Published Date: Apr 26, 2022
Abstract
Background: Mechanical valve thrombosis (MVT) is a severe complication of heart valve
replacement. In this study we presented our surgical experience for left-sided MVTs.
Methods: From October 2010 through January 2022, 1418 operations of mechanical valve
replacement in 1252 patients. 59 patients were operated for left-sided MVT. Preoperative, operative
and postoperative data were collected.
Results: In this study 48 (81%) of patients were women, the mean age was 46.7±13.2 years. Mitral
valve was thrombosed in 51 patients (86%) and aortic valve in 8 patients (14%). The most frequent
clinical presentation was dyspnea III-IV (58%). The time interval between first valve replacement
and MVT was 58.6 ± 38.4 months. INR was less than 2 in 37 patients (63%) patients. All patients
underwent a surgical procedure; thrombectomy in 21 patients (36%), valve replacement in 38 patients
(64%). Early mortality was (12%).
Conclusion: MVT is a serious complication of valve replacement. Early diagnosis and early surgery
gives excellent outcomes. The best means of prevention is effective anticoagulation.
Keywords: Mechanical Valve; Thrombosis; Cardiac Surgery; Thrombectomy; Valve Replacement
Cite this article as: Sami Bouchenafa, Ahmed Zaki Boukli Hacene, Boukri Hamouda, et al. 2022.
Surgical treatment of left-sided mechanical valve thrombosis: Twelve years’ experience. J Cardiovasc
Surg Heart Dis. 4: 68-74.
Copyright: This is an open-access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium,
provided the original author and source are credited. Copyright © 2022; Sami Bouchenafa
Introduction
Mechanical valves have long term durability,
but some complications may occur. MVT is
caused by a thrombus attached to a mechanical
valve interfering with it function. Endmunds
defined MTV as a complication attributable to
any type of thrombus, without evidence of
infection, attached around a mechanical valve,
deranging hemodynamics, or interfering with
valvular function [1]. The incidence of
thrombosis ranges from 0.5% to 6% in the
aortic and mitral positions [2,3]. The annual
rate of prosthetic valve thrombosis with
mechanical valve ranges from 0.1% to 5.7%
[4]. Diagnosis can be made with variable
clinical presentations related with the degree of
valvular obstruction. Physical examination is
frequently insufficient, and diagnosis of valve
thrombosis is established by fluoroscopy,
transthoracic echocardiography (TTE) and
transesophageal echocardiography (TEE) [5,6].