Prosthetic Heart Valve Thrombosis
(Prosthetic Valve Thrombosis; PVT)
Prosthetic heart valve thrombosis is a rare, but serious problem that can happen after a heart valve replacement procedure. A blood clot called a thrombus is attached to or near the new heart valve. This can block blood flow or keep the valve from working as it should.
Prosthetic heart valve thrombosis is an emergency. Medical care is needed right away.
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Prosthetic heart valve thrombosis is thought happen due to a reaction between the blood and the new valve, or blood flow in and around it.
Things that may raise the chance of prosthetic heart valve thrombosis include:
- Not getting enough blood thinning treatment after the valve replacement
- The new valve is at the heart's mitral valve
- Atrial fibrillation
- Some medicines
- Cancerous tumors
- Systemic diseases such as systemic lupus erythematosus, or swelling and harm to body tissues, such as joints, skin, kidneys, heart, lungs, blood vessels, and brain
- The heart is not pumping as much—possibly due to heart failure
Prosthetic heart valve thrombosis may cause:
- Shortness of breath
- Trouble breathing while lying down
- Fatigue and problems working out
- Chest pain, burning, or pressure
- Loss of consciousness
The doctor will ask about symptoms and health history. A physical exam may be done.
Images may be need to check the heart and chest. These may include:
Blood tests may also need to be done
The goal of treatment is to get rid of any blockages to help blood flow better. This may be done with:
For people who have gotten new heart valves, medicine to reduce blood clotting may help lower the chance of prosthetic heart valve thrombosis.
Medicines are given that can break up the blood clots. This is often the first thing done to help with thrombosis.
Medicines may be given to control how the blood clots. Anticoagulation therapy may be used alone in people with small clots that are not blocking the heart valve.
Surgery may be needed to replace the valve.
- Anticoagulation overview. EBSCO DynaMed website. Available at: https://www.dynamed.com/drug-review/anticoagulation-overview.
- Özkan, M., Gündüz, S., et al. Thrombolysis or surgery in patients with obstructive mechanical valve thrombosis: the multicenter HATTUSHA study. Journal of the American College of Cardiology, 2022; 79: 977-989.
- Prosthetic heart valve dysfunction. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/prosthetic-heart-valve-dysfunction.
- Roudaut, R., Serri, K., et al. Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations. Heart, 2007; 93 (1): 137-142.
- Michael J. Fucci, DO, FACC
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