Heart Diseases

Biography

Biography: Srinivasa Kumaran

Abstract

Statement of the Problem: Prosthetic valve thrombosis is a rare but serious complication of valve replacement, most often encountered with mechanical prostheses. The incidence of prosthetic valve thrombosis varies according to the following variables: efficacy of anticoagulation; type and location of the implanted prosthesis; and presence of atrial fibrillation. Obstruction of the prosthesis is more frequent during the first postoperative year. The clinical findings vary from lack of symptoms to extreme cases of cardiogenic shock. The most common symptoms are progressive dyspnea on exertion, lipothymia, and syncope. Systemic embolism and acute pulmonary edema may also be the first manifestations of the disease. For any given patient, the risks of thrombolytic therapy, including bleeding, systemic embolism, and failure to restore valvular function, must be weighed against the risks of surgical intervention. Once the decision is made to operate, the choice of valve replacement versus debridement is best made intraoperatively, upon visual inspection of the valve apparatus. We report a case of a perimenopausal woman who underwent mitral valve replacement 4 years back presenting with symptoms of congestive cardiac failure. The patient was diagnosed with valve thrombosis from a transthoracic echocardiogram and underwent valve replacement. The relevant literature is reviewed.