Mahindru Supaksh, Pande Shantanu, Malhotra Pulkit, Thukral Ankit, Kotwal Ankush Singh, Gupta Rajan Prasad, Garg Naveen, Kapoor Aditya, Agarwal Surendra Kumar
Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Indian J Thorac Cardiovasc Surg. 2021 Mar;37(2):140-146. doi: 10.1007/s12055-020-01041-9. Epub 2020 Nov 7.
The incidence of prosthetic valve dysfunction (stuck valve) is variable and is dependent on various factors. There are studies from Indian groups that have emphasized the success of thrombolysis; however, none of them reported a follow-up. This study was designed to emphasize on the follow-up of these patients at midterm.
The patients of prosthetic valve thrombosis between period of January 2013 and December 2017 were included in this retrospective observational study. Sixty-six patients were admitted with stuck valve during this period. Thrombolysis was preferred modality of treatment. Survivors were followed up with serial echocardiography, which included estimation of left ventricular and valve functions.
Of a total of 66 patients, 59 were of stuck mitral valve and 7 stuck aortic valve. The event happened at a mean of 48.86 ± 48.80 months after index operation of valve replacement using mechanical valve prosthesis. The median age was 40.27 ± 10.8 years with 39 males and 27 females. Thrombolysis was successful in 61 patients with a mortality of 5 (7.57%). During a mean follow-up of 22.7 ± 20.9 months, 42 patients were alive with 14 (22.95%) patients dead and 5 patients lost to follow-up. The average follow-up was 18.7 ± 22.7 months before death.
Following good early results after thrombolysis, patients of prosthetic heart valve thrombosis experience high mortality within 2 years of follow-up. These patients require frequent follow-up to avoid early mortality.
人工心脏瓣膜功能障碍(瓣膜卡滞)的发生率各不相同,且取决于多种因素。印度的一些研究小组强调了溶栓治疗的成功率;然而,他们均未报告随访情况。本研究旨在强调对这些患者进行中期随访。
本回顾性观察研究纳入了2013年1月至2017年12月期间发生人工心脏瓣膜血栓形成的患者。在此期间,66例患者因瓣膜卡滞入院。溶栓是首选的治疗方式。对幸存者进行了系列超声心动图随访,包括评估左心室和瓣膜功能。
在总共66例患者中,59例为二尖瓣卡滞,7例为主动脉瓣卡滞。该事件发生在使用机械瓣膜假体进行瓣膜置换手术的平均48.86±48.80个月后。中位年龄为40.27±10.8岁,其中男性39例,女性27例。61例患者溶栓成功,5例(7.57%)死亡。在平均22.7±20.9个月的随访期间,42例患者存活,14例(22.95%)患者死亡,5例患者失访。死亡前的平均随访时间为18.7±22.7个月。
溶栓治疗取得良好早期效果后,人工心脏瓣膜血栓形成患者在随访的2年内死亡率较高。这些患者需要频繁随访以避免早期死亡。