A Study of Indications, Complications of Prosthetic Valves and Prognosis After Treatment of Stuck Valve

Abstract

BACKGROUND Implantation of prosthetic cardiac valves to treat haemodynamically significant valvular diseases has become common; however, it is associated with complications. Thus, this study was intended to evaluate the indications for implantation of prosthetic valve and complications after its implantation and prognosis after treatment of one of its complication, i.e. stuck valve. MATERIALS AND METHODS This was a single-centered study wherein 50 patients who came to the emergency department with stuck valve were assessed. The 2D echocardiography was performed in all patients. Thrombolysis was done and the gradients were reassessed. Further response to treatment and development of complications before and after treatment were observed. RESULTS Of total patients, 60% were females. Mean age group was 30-40 yrs. Most of them were asymptomatic for 6 years and there was lack of compliance in 90% of patients. Most common indication for valve replacement was mitral stenosis (60%) followed by mitral regurgitation (20%), aortic regurgitation and aortic stenosis (10%) and combined mitral and tricuspid regurgitation (10%). Commonest valve was St. Jude (90%). Pannus was observed in 10% patients and thrombus was observed in 50% patients. Most patients had gradients 45/20 mmHg across mitral valve. In about 90% patients, gradients decreased after thrombolysis (12/5 mmHg). The complications after thrombolysis were hemiparesis (4%), death before thrombolysis (6%) and death after thrombolysis (4%). CONCLUSION Considering these results, it can be concluded that prosthetic valves are seldom associated with some complications. Further, thrombolysis can be effective in patients with prosthetic valve thrombosis.