Abstract
Thrombotic and thromboembolic events are important causes of mortality and morbidity in patients with prosthetic heart valve. The aim of this study is to evaluate the factors that may contribute to prosthetic heart valve thrombosis. This was a cross-sectional study in Rajaie Heart Center on patients with prosthetic heart valve malfunction, within a year. According to the echocardiographic and fluoroscopic findings, the patients were divided into two groups (thrombosis and non-thrombosis groups). The patients' demographic, clinical and laboratory data were recorded and analyzed with SPSS software. A total of 142 patients participated in this study. Ninety-four patients (66.2%) were diagnosed with thrombosis. There was a significant relationship between thrombosis and inadequate anti-coagulation (international normalized rati [INR] <2.5) (odds ratio [OR]: 4.15, 95% CI: 1.98-9.87, P = 0.003), history of infection (OR: 12.81, 95% CI: 3.52-19.02, P<0.001), prothrombin time (PT) check interval (OR: 2.38, 95% CI: 1.63-8.47, P = 0.019), atrial fibrillation (AF) rhythm (OR: 3.96, 95% CI: 1.75-8.09, P = 0.019), and plasma fibrinogen level (OR: 6.90, 95% CI: 2.58-14.69). Based on this study, inadequate anti-coagulation, AF rhythm, recent infection and plasma fibrinogen level were the factors most contributing to prosthetic valve thrombosis. As there were many cases of thrombosis in patients with history of infection, this factor can be considered for risk assessment in prosthetic valve.
Highlights
An average of 350 000 heart valves are replaced worldwide every year.[1]
Prosthetic Valve Thrombosis (PVT) results in valve malfunction, thromboembolic events, the clot serving as a nest for viral or bacterial growth, etc.[7]
This study aims to assess the risk factors and incidence of prosthetic valve thrombosis in patients with prosthetic valve malfunction
Summary
An average of 350 000 heart valves are replaced worldwide every year.[1]. The main objective of valve replacement is to expand life expectancy and improve life quality in patients who have significant symptoms.[2]. There is an incidence rate of thrombosis of approximately 0.1% to 5.7% in mechanical heart valves and 0.03% in biological heart valves, reported every year. It is reported that thrombosis occurs by a rate between 0.1 to 6.0% for each year of patient’s age, in the mitral and the aortic valves and up to 20% in the tricuspid valve.[4] Diagnostic techniques including echocardiography, fluoroscopy, and therapeutic measures involving re-surgery, thrombolytic therapy, or anti-coagulant treatments impose significant costs on individuals and the whole community.[5,6] Prosthetic Valve Thrombosis (PVT) results in valve malfunction, thromboembolic events, the clot serving as a nest for viral or bacterial growth, etc.[7] This study aims to assess the risk factors and incidence of prosthetic valve thrombosis in patients with prosthetic valve malfunction. The aim of this study is to evaluate the factors that may contribute to prosthetic heart valve thrombosis. Conclusion: Based on this study, inadequate anti-coagulation, AF rhythm, recent infection and plasma fibrinogen level were the factors most contributing to prosthetic valve thrombosis.
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