Definition

Prosthetic heart valve thrombosis is a rare but serious complication of a heart valve replacement procedure . The complication occurs when a thrombus (blood clot) is attached to or near a prosthetic heart valve. This can obstruct blood flow or interfere with the function of the valve. This condition can be life-threatening. Seek medical attention immediately if you think you have prosthetic heart valve thrombosis.

Heart Valves With Prosthetic Replacements

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Causes

Prosthetic heart valve thrombosis is thought to result from an interaction between components of blood and the prosthesis or turbulent blood flow in and around the prosthesis.

Risk Factors

The following factors may increase your chance of developing prosthetic heart valve thrombosis. If you have any of the following risk factors, tell your doctor:

  • Inadequate anticoagulant therapy after a valve transplant
  • Prosthesis located at the mitral valve in the heart
  • Atrial fibrillation
  • Drugs (eg, contraceptives)
  • Cancerous tumors
  • Systemic diseases (eg, systemic lupus erythematosus , inflammation and damage to various body tissues, including joints, skin, kidneys, heart, lungs, blood vessels, and brain)
  • Reduced cardiac pumping (low ejection fraction)

Symptoms

  • Shortness of breath
  • Difficulty breathing while lying down
  • Waking at night short of breath
  • Swelling
  • Fatigue
  • Difficulty exercising
  • Chest pain, burning, or pressure
  • Nausea
  • Numbness
  • Loss of consciousness
  • Stroke
  • Transient ischemic attack
  • Absence or lessening of prosthetic noise

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include the following:

  • Echocardiogram —a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
  • Blood tests
  • Fluoroscopy—an x-ray technique

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Thrombolysis

The first line of therapy is usually thrombolysis, which uses medications to break up abnormal blood clots.

Anticoagulation Therapy

Anticoagulant medications are used to control clotting. Anticoagulation therapy may be used alone in people with small clots that are not obstructing the heart valve.

Valve Replacement

In some cases, surgery to replace the valve may be necessary.

Prevention

In people who have prosthetic heart valves, antithrombotic therapy (eg, warfarin and aspirin) may help reduce the risk of prosthetic heart valve thrombosis.