Prosthetic Valve Thrombosis: A Clinical, Echocardiographic and Cinefluoroscopic Study with Special Reference to Thrombolytic Therapy

Background: Prosthetic valve thrombosis (PVT) is a rare but serious complication of valve replacement, most often encountered with mechanical prostheses. The significant morbidity and mortality associated with this condition warrants rapid diagnostic evaluation. Transthoracic, TEE and Cinefluoroscopy represent the main diagnostic procedures. Methods: The present study is an institutional based single centre prospective and retrospective observational study conducted in patients who are admitted with diagnosis of prosthetic valve thrombosis to the Department Of Cardiology, Gandhi Medical college/Hospital, Secunderabad, Telangana, India. The study was conducted between April 2016 to February 2018. A total of 66 patients admitted to the department of cardiology with a diagnosis of prosthetic valve thrombosis. Results: A total of 66 patients included in this study had mean age of 35.2 10.5 years and 43 (65.15 %) are females and 23 (34.85 %) are males.58 (87.88 %) patients underwent MVR, 4 (6.06 %) underwent AVR and 4 (6.06 %) underwent DVR. Thrombolytic agent used was streptokinase in 65 (98.48 %) patients and 1 (1.52 %) received tenecteplase. The thrombolytic therapy was successful in 33 (50 %) patients, partially successful in 12 (18.18 %) and failure in 21 (31.82 %). In this study the overall success rate in 45 (68.18 %) patients. Among 66 patients, 4 patients not achieved clinical and hemodynamic improvement and 17 patients died. Complications during this study are 3 patients developed CVA because of embolism. CONCLUSION: Prosthetic valve thrombosis is an urgent life threatening medical emergency, which warrants rapid diagnostic assessment. Thrombolytic therapy is an effective and easily available treatment modality which can be rapidly instituted in patient with prosthetic valve thrombosis.