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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. 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    TOP

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    TOP

Factors that may increase your chances 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
  • Certain medications
  • 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    TOP

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    TOP

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    TOP

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    TOP

In some cases, surgery to replace the valve may be necessary.

Prevention    TOP

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
https://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:

Anticoagulation overview. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated August 14, 2017. Accessed September 15, 2017.
Heart valve surgery. Mount Sinai website. Available at:
...(Click grey area to select URL)
Accessed September 15, 2017.
Prosthetic heart valve dysfunction. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated May 31, 2017. Accessed September 15, 2017.
Roudaut R, Serri K, Lafitte S. Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations. Heart. 2007;93(1):137-142.
Last reviewed September 2017 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 5/2/2014

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