Diagnosis of mechanical prosthetic valve thrombosis or obstruction
- Sorin Pislaru, MD, PhD
Sorin Pislaru, MD, PhD
- Professor of Medicine
- Department of Cardiovascular Diseases
- Mayo Clinic
- Heidi M Connolly, MD, FASE
Heidi M Connolly, MD, FASE
- Section Editor — Congenital Heart Disease
- Professor of Medicine
- Mayo Medical School
Replacement of a diseased heart valve with a prosthetic heart valve exchanges the native disease for prosthesis-related complications [1-3]. Complications include prosthetic valve obstruction (including thrombosis and pannus formation), patient-prosthesis mismatch, embolic events, bleeding, prosthetic heart valve regurgitation (valvular and paravalvular), infective endocarditis, and prosthetic valve-related hemolysis.
Thrombus forming on a mechanical prosthetic valve can be nonobstructive or obstructive and may or may not cause clinical thromboembolic events [4-7].
Diagnosis of mechanical prosthetic valve thrombosis and obstruction are reviewed here. Related issues including when to suspect prosthetic valve thrombosis and obstruction and how to start the evaluation are reviewed separately:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- GENERAL APPROACH TO EVALUATION
- Initial evaluation
- Approach to further evaluation
- - Choice between TEE or MDCT
- General recommendations
- Additional factors to consider
- Characteristics of imaging tests
- - Transesophageal echocardiography
- - Multidetector computed tomography
- - Fluoroscopy
- - Exclude prosthetic valve endocarditis
- - Identify thrombus or pannus
- Approach to presumptive diagnosis
- Features of thrombus and pannus
- SPECIFIC APPROACH BASED UPON PRESENCE OR ABSENCE OF OBSTRUCTION
- Approach to mechanical valve obstruction
- - If moderate to severe symptoms
- - If no or mild symptoms
- Approach to suspected valve thrombosis without obstruction
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS