Non-obstructive prosthetic heart valve thrombosis (NOPVT): Really a benign entity?

Mutuberria-Urdániz, M.; Rodríguez-Palomares, José F.; Ferreira, Ignacio; Bañeras, Jordi; Teixidó, Gisela; Gutiérrez, Laura; Zavala, German; González‐Alujas, M.T.; Evangelista, Artur; Tornos, Pilar; Garcı́a-Dorado, David

doi:10.1016/j.ijcard.2015.06.021

Cited by 7 publications

(10 citation statements)

References 32 publications

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“…In hemodynamically stable patients with PVT, clinically in NYHA class I-II and small thrombus (<0.8 cm 2 ), treatment with continuing a sufficient anticoagulation with a vitamin K antagonist (VKA) seems to be reasonable, and in most cases the treatment of choice. 8 In patients with hemodynamic instability, a regimen of intravenous heparin should be started, followed by either thrombolysis or surgery. 9 If NYHA functional class is III-IV and a large thrombus is present, emergent surgery is usually recommended.…”

Section: Discussionmentioning

confidence: 99%

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Mechanical Aortic Valve Thrombosis with Heart Failure Successfully Treated with Oral Anticoagulation: A Case Report

Ababneh,

Al-Kasasbeh,

Algorani

2023

VHRM

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Background:The use of anticoagulation is mandatory for prevention of prosthetic valve thrombosis (PVT) worldwide, regardless of the valve type or position in the heart. In case a thrombosis causes symptomatic dysfunction, treatment usually includes the use of thrombolytic therapy or surgery. We report a case of PVT involving a patient with a mechanical aortic valve which was treated entirely with the use of anticoagulation therapy (warfarin). Case Presentation: A 58-year-old man had an aortic valve replacement using a Carbomedics ® mechanical valve due to severe aortic stenosis as a result of a calcific bicuspid native aortic valve. He was commenced on warfarin after surgery which was continued thereafter. He presented to our hospital after three years with shortness of breath at rest. On clinical examination, his condition was poor with a New York Heart Association functional classification of IV. He was in sinus rhythm and had an enlarged heart shadow on chest X-ray. Transesophageal echocardiography (TEE) revealed aortic valve regurgitation with vegetations on the anterior valve leaflet causing reduced hemi leaflet motility and a mean pressure gradient of 50 mmHg. Cinefluoroscopy revealed a dysfunctional mechanical valve leaflet. Surgery was at high risk of mortality due to the patient's clinical status and he was continued on warfarin therapy with close monitoring. Cinefluoroscopy and echocardiography done six months later revealed complete dissolution of thrombus and a normally functioning mechanical aortic valve. Conclusion: Only a few cases of symptomatic, thrombotic mechanical aortic valve were entirely treated with anticoagulation only. Our patient is one such case who had resolution of symptoms and improvement on NYHA functional classification (IV to I).

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Section: Discussionmentioning

confidence: 99%

“…In hemodynamically stable patients with PVT, clinically in NYHA class I–II and small thrombus (<0.8 cm 2 ), treatment with continuing a sufficient anticoagulation with a vitamin K antagonist (VKA) seems to be reasonable, and in most cases the treatment of choice. 8 …”

Section: Discussionmentioning

confidence: 99%

Mechanical Aortic Valve Thrombosis with Heart Failure Successfully Treated with Oral Anticoagulation: A Case Report

Ababneh,

Al-Kasasbeh,

Algorani

2023

VHRM

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“…La TVPNO es una complicación severa que requiere un abordaje diagnóstico y terapéutico inmediato. Se define como la presencia de una masa blanda, móvil o fija, localizada en la oclusión de la válvula protésica o en los sitios de sutura, asociada a gradientes transprotésicos conservados (1) .…”

Section: Discussionunclassified

Trombosis no obstructiva de válvula protésica en postoperatorio de reemplazo valvular mitral

M’rad

Barba

Fallabrino

et al. 2021

Rev Ecocar Pract (RETIC)

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La trombosis valvular protésica no obstructiva es una entidad de creciente diagnóstico en la actualidad. A continuación presentamos a una paciente de 74 años con antecedente de insuficiencia mitral severa funcional a quien se le realizó un reemplazo valvular mitral con una prótesis biológica. Durante el postoperatorio inmediato se realizó ecocardiograma transesofágico con evidencia de trombo en aurícula izquierda sobre la bioprotésis en ausencia de gradiente transvalvular aumentado. En dicho contexto se decidió tratamiento anticoagulante con heparina y, luego, antivitamínicos K, con buena evolución.

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“…On a similar note, there was one study looking only at non-obstructive PVT had 97% mitral involvement in their series. [9] There were three important meta-analysis/systematic reviews related to the management of PVT comparing TT versus surgery, from which the European and American guidelines were derived. Two of these meta-analysis did not differentiate obstructive and non-obstructive PVT patients in their analysis.…”

Section: Methodsmentioning

confidence: 99%

Thrombolysis in high-risk patients with left-sided obstructive prosthetic valve thrombosis

Showkathali¹,

Yalamanchi²,

Oomman³

et al. 2020

Kardiol Pol

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Non-obstructive prosthetic heart valve thrombosis (NOPVT): Really a benign entity?

Cited by 7 publications

References 32 publications

Mechanical Aortic Valve Thrombosis with Heart Failure Successfully Treated with Oral Anticoagulation: A Case Report

Mechanical Aortic Valve Thrombosis with Heart Failure Successfully Treated with Oral Anticoagulation: A Case Report

Trombosis no obstructiva de válvula protésica en postoperatorio de reemplazo valvular mitral

Thrombolysis in high-risk patients with left-sided obstructive prosthetic valve thrombosis

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