MITRAL VALVE THROMBOSIS; TWO YEARS’ EXPERIENCE IN THE NATIONAL HEART INSTITUTE
M.H. Mazen*, Nashaat Abd Elhamied*, Hussein Nofal*, M. Essafti*, Mohamed Elasheri*, Waleed Abbass Kamel*, Mona Ramdan≠
*Department of Cardiac surgery, Nationional Heart Institute
≠Department of Anesthesia department at National heart institute
Introduction: An acute valve obstruction is a serious life-threatening complication of mechanical valve prostheses. The significant morbidity and mortality associated with this condition warrants rapid diagnostic evaluation. Valve obstruction is caused by the formation of fresh thrombus or fibrous tissue overgrowth, or both, at or over the prosthetic heart valve. Diagnosis is challenging regarding time and differential diagnosis. Cinefluoroscopy and transthoracic and transesophageal echocardiography are the main diagnostic procedures. Accurate selection of the most appropriate treatment for a particular patient is mandatory. Patients and Methods: This study involved all patients (n=152) referred to Cardiac Surgery Department of National Heart Institute with mitral valve thrombosis from January, 2012 to December, 2013. Patients who were referred to the Emergency Department with a diagnosis of malfunction prosthetic valve candidate for thrombolysis were excluded from this study. Discussion and conclusion: Diagnosis of prosthetic obstruction is generally based on the presence of certain clinical, echocardiographic, fluoroscopic, and hemodynamic features. Patients from far areas have a higher incidence of thrombosis of their prosthetic valves 103 (67.7%). Pregnant women represent a special problem due to the hypercoagulable state during pregnancy. We believe that the changing of anticoagulation in the first and third trimester to UFH, and to warfarin again in the second trimester and after delivery mainly causes this high percentage. We believe that patients are given a good chance of survival by performing reoperation, not at NYHA class IV, but at class II or III.