{"id":3850,"date":"2010-03-04T02:32:06","date_gmt":"2010-03-04T02:32:06","guid":{"rendered":"http:\/\/cardiophile.org\/?p=3850"},"modified":"2010-03-04T02:32:06","modified_gmt":"2010-03-04T02:32:06","slug":"prosthetic-valve-thrombosis","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/prosthetic-valve-thrombosis\/","title":{"rendered":"Prosthetic valve thrombosis"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/h3qmDrKRqEk\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Prosthetic valve thrombosis<\/span><\/h2>\n<p>Obstruction of a prosthetic valve by a non infective thrombus is what we mean by prosthetic valve thrombosis. Size of the thrombus is important in deciding the management.<\/p>\n<p><strong><span style=\"color: #0000ff;\">Pathophysiology<\/span><\/strong><\/p>\n<ol>\n<li><em>Endothelial factors:<\/em> Suture zone endothelialization occurs in 3-4 weeks. Risk of thrombosis is higher prior to endothelialization if anticoagulation is suboptimal.<\/li>\n<li><em>Hemodynamic factors:<\/em> Localised region of turbulent flow causes endothelial trauma, and damage to blood cells, releasing adenosine diphosphate (ADP) which promote platelet aggregation.<\/li>\n<li><em>Coagulation factors<\/em><\/li>\n<\/ol>\n<p><strong><span style=\"color: #0000ff;\">Predisposing factors<\/span><\/strong><\/p>\n<p>Insufficient anticoagulation, mitral\/tricuspid position, hypercoagulable state, presence of associated atrial thrombus.<br \/>\nPannus can occur along with the thrombus as well.<\/p>\n<p><strong><span style=\"color: #0000ff;\">Diagnosis<\/span><\/strong><\/p>\n<p><strong><em>Clinical presentations<\/em><\/strong><\/p>\n<ol>\n<li>Clinically silent prosthetic valve thrombosis.<\/li>\n<li>Prosthetic valve thrombosis with embolic episodes like cerebral, coronary or peripheral embolism can occur in up to 25% cases.<\/li>\n<li>Hemodynamic problem with evidence of valve thrombosis.<\/li>\n<\/ol>\n<p>Prosthetic valve thrombosis can present with fever in the setting of infective endocarditis. Fever can occur in prosthetic valve thrombosis even without endocarditis.<\/p>\n<p><span style=\"color: #0000ff;\">High resolution sound spectrograph<\/span> can detect valve thrombosis by the change in the valve sounds. This is probably similar to suspicion of thrombosis when audible valve sound intensity decreases clinically. Patients are routinely instructed to listen for the valve sounds in a quiet room and report back if there is a decrease in intensity.<\/p>\n<p><span style=\"color: #0000ff;\">Cine fluoroscopy<\/span> is useful as it can detect decreased leaflet and poppet movements as well as abnormal movement of the valve cage.<\/p>\n<p><span style=\"color: #0000ff;\">Echocardiography<\/span> is an important tool for evaluation of prosthetic valve thrombosis. Thrombus can be visualised by echocardiography, better with transesophageal than transthoracic echocardiography. Gradients and valve areas can be estimated. <span style=\"color: #0000ff;\">Dimensionless obstruction indexes<\/span> are the ratio of subvalvular\/valvular velocities and velocity time integrals.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Prosthetic valve thrombosis: Obstruction of a prosthetic valve by a non infective thrombus is what we mean by prosthetic valve thrombosis. Size of the thrombus is important in deciding the management.<\/p>\n","protected":false},"author":1,"featured_media":29124,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-3850","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Prosthetic valve thrombosis: Obstruction of a prosthetic valve by a non infective thrombus<\/title>\n<meta name=\"description\" content=\"Prosthetic valve thrombosis: Obstruction of a prosthetic valve by a non infective thrombus is what we mean by prosthetic valve thrombosis. Size of the thrombus is important in deciding the management.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/prosthetic-valve-thrombosis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Prosthetic valve thrombosis: Obstruction of a prosthetic valve by a non infective thrombus\" \/>\n<meta property=\"og:description\" content=\"Prosthetic valve thrombosis: Obstruction of a prosthetic valve by a non infective thrombus is what we mean by prosthetic valve thrombosis. 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