Incidence of Prosthetic Valvular Thrombosis in Rheumatic Heart Valve Diseases and Risk Factors for Mortality: Experience from a Tertiary Care Center with Review of Management Options

Abstract

Background Prosthetic valve thrombosis bears significant risks of morbidity and mortality. In our study, we explore the risk factors associated with thrombolysis for thrombosis of prosthetic valves of the heart. Materials and Methods This is a hospital-based cross-sectional study with 60 patients with valve replacement between 25 and 60 years. Using an organized questionnaire we have obtained data on sociodemographic, behavioral risk factors, and previous history of other medical conditions. Results and Discussion The incidence of prosthetic valve thrombosis was 4% ( n = 60). The prevalence of aortic valve thrombosis was found to be 3.4% and mitral valve thrombosis was 5.2%. The mean age group of the study population was 30 ± 10 years. The incidence was highest (31%) in the 30–40 years age group. Aortic valve thrombosis was the most common ( n = 48, 80%). The overall mortality was 38% ( n = 23). The mortality rate due to Aortic valve and Mitral valvar thrombosis was 41.06% ( n = 20) and 20% ( n = 3), respectively. Sub-therapeutic international normalized ratio (INR) was noted in 86% ( n = 52) patients and drug non-compliance was 70% ( n = 42). All patients underwent thrombolysis, considering the higher severity of functional class. The risk factors significant for mortality were previous history of valve thrombosis, subtherapeutic INR and aortic valve. Conclusions Aoretic valve prosthetic valve thrombosis was the most common and the overall mortality was higher in women. High mortality was observed in the cohort. Previous history of thrombosis and subtherapeutic INR is an important risk factor for mortality.