Mechanical tricuspid valve thrombosis: A midterm follow-up study.

Abstract

The incidence of prosthetic tricuspid valve (TV) thrombosis is the highest among heart valves. It can lead to high morbidity and mortality without proper treatment. In this study, we sought to report the management and clinical outcomes of patients with mechanical TV thrombosis. The current study was conducted in Rajaei Heart Center on 42 patients with mechanical TV thrombosis from 2006 to 2017. The baseline characteristics and the rates of adverse events during the follow-up period were assessed. A total of 67 episodes of mechanical TV thrombosis in 42 patients were observed. The mean age of patients was 45.5 ± 14.3 years (19-77), and overall two-thirds were female. Thrombolytic therapy was used in 41 (61.1%), anticoagulant intensification in 16 (23.9%), and surgery as the first approach in 10 (14.9%) episodes; subsequently, surgery as the final approach was implemented in 20 (29.8%) episodes. In-hospital mortality occurred in two (2.98%) patients. The rates of freedom from recurrent thrombosis were 84%, 61%, and 21% at the end of 1, 4, and 10 years, respectively. Survival rates and freedom from chronic valve dysfunction were 93%, 82%, and 75% after 1, 4, and 10 years. The results of the present study showed that recurrent thrombosis requiring intervention is a major complication of mechanical TV, which underscores individual-approached therapy and close follow-up.