Bonou M, Lampropoulos K, Barbetseas J. Prosthetic heart valve obstruction: thrombolysis or surgical treatment?
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2013;
1:122-7. [PMID:
24062899 DOI:
10.1177/2048872612451169]
[Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Accepted: 05/19/2012] [Indexed: 11/16/2022]
Abstract
Prosthetic valve thrombosis is a potentially life-threatening complication associated with high morbidity and mortality. Transthorasic and transoesophageal echocardiography play an important role to the diagnosis and provides incremental information about the optimal treatment strategy, while fluoroscopy and cardiac computed tomography may be of added value. Guidelines differ on whether surgical treatment or fibrinolysis should be the treatment of choice for the management of left-sided prosthetic valve thrombosis and these uncertainties underline the need for further prospective randomized controlled trials. Thrombus size, New York Heart Association functional class of the patient, the possible contraindications, the availability of each therapeutic option and the clinician's experience are important determinants for the management of prosthetic valve thrombosis.
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