Abstract
Objective: Valve thrombosis defined as any thrombus not caused by infection attached to or near an operated valve that occludes part of the blood flow path and interferes with valve function. Treatment modalities are thrombolytic therapy, surgical thrombectomy and debridement, or re-replacement. The aim of this study is to review our experience in surgical thrombectomy and debridement for obstructed mechanical valve prosthesis, and the impact of the procedure on the outcome in comparison to re-replacement; Methods: The study was conducted retrospectively between 1995 to 2012 in Department of Cardiothoracic surgery, cardiology and internal medicine, Zagazig University Hospital. 92 patients with stuck valve were divided into two groups. Group (A): 54 patients with re replacement and Group (B): 38 patients treated by thrombectomy and debridement; Results: 92 patients with stuck valves the mean age was 38.4(±9.2), 68 male and 85 female in both groups. The large numbers of cases were mitral valve 35 (64.8%) patients in group A and 22 (57.9%) patients in group B, aortic malfunction in group A was 11 (20.4%)patients and 9 (23.7%) cases in group B, double valve malfunction was rare represent 8 (14.8%) and 7 (18.4%)cases in group A and group B respectively; Conclusion: We conclude that thrombectomy and debridement for malfunctioning mechanical valve is a safe, easy and rapid procedure to perform in some cases to avoid the risk of re replacement.
Highlights
Prosthetic valve obstruction is a life-threatening complication after valve replacement [1]
The aim of this study is to review our experience in surgical thrombectomy and debridement for obstructed mechanical valve prosthesis, and the impact of the procedure on the outcome in comparison to re-replacement; Methods: The study was conducted retrospectively between 1995 to 2012 in Department of Cardiothoracic surgery, cardiology and internal medicine, Zagazig University Hospital. 92 patients with stuck valve were divided into two groups
The large numbers of cases were mitral valve 35 (64.8%) patients in group A and 22 (57.9%) patients in group B, aortic malfunction in group A was 11 (20.4%)patients and 9 (23.7%) cases in group B, double valve malfunction was rare represent 8 (14.8%) and 7 (18.4%)cases in group A and group B respectively; Conclusion: We conclude that thrombectomy and debridement for malfunctioning mechanical valve is a safe, easy and rapid procedure to perform in some cases to avoid the risk of re replacement
Summary
Prosthetic valve obstruction is a life-threatening complication after valve replacement [1]. The etiology usually due to Obstructionwhich caused by thrombus and/or punnus formation. Valve thrombosis defined as any thrombus not caused by infection attached to or near an operated valve that occludes part of the blood flow path and interferes with valve function, or is sufficiently large to needs treatment [2]. The clinical presentation of mechanical prosthetic valve obstruction varies from mild symptoms, progressive heart failure, embolic manifestations, or hemodynamic compromise [3]. Treatment modalities are thrombolytic therapy, surgical thrombectomy, or replacement. The purpose of this study is to review our experience in surgical thrombectomy for obstructed mechanical valve prosthesis, and the efficacy and impact of the procedure on the outcome
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