Prosthetic Heart Valve Thrombosis

Definition

Prosthetic heart valve thrombosis is a rare, but serious complication of a heart valve replacement procedure. A blood clot called a thrombus is attached to or near a prosthetic heart valve. This can obstruct blood flow or interfere with the function of the valve.

Prosthetic heart valve thrombosis is a medical emergency.

Heart Valves With Prosthetic Replacements

Causes

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

Risk Factors

Factors that may increase your chances of prosthetic heart valve thrombosis include:

• Inadequate anticoagulant/blood thinning therapy after a valve transplant
• Prosthesis located at the mitral valve in the heart
• Atrial fibrillation
• Certain medications
• Cancerous tumors
• Systemic diseases such as systemic lupus erythematosus, or inflammation and damage to various body tissues, including joints, skin, kidneys, heart, lungs, blood vessels, and brain
• Reduced cardiac pumping—possibly from heart failure

Symptoms

Prosthetic heart valve thrombosis may cause:

• Shortness of breath
• Difficulty breathing while lying down
• Swelling
• Fatigue
• Difficulty exercising
• Chest pain, burning, or pressure
• Nausea
• Numbness
• Loss of consciousness

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam may be done.

Images evaluate your heart and surrounding structures. These may include:

• Echocardiogram
• Fluoroscopy

Your bodily fluids may need to be tested. This can be done with blood tests.

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 are medications that 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 is the best proven way to reduce your chance of prosthetic heart valve thrombosis.