Surgery of prosthetic valve thrombosis.

From January 1978 to August 1983, 41 prosthetic valve thromboses in 34 patients were operated upon in our service. They comprised 15 aortic, 25 mitral and one tricuspid valve thromboses. Seven patients had massive thrombus with dysfunction of the prosthesis; others had small and disseminated thrombi on their prosthesis (34 patients). In the aortic position, valve thrombosis occurred on 10 ball valves and 5 pivoting disc valves. In the mitral position, they occurred on 17 ball valves, 7 pivoting disc valves and one bioprosthesis. In 2 cases, aortic valve thrombectomy was successfully done. Others had valve replacement. Hospital mortality was high: 13 deaths. Survivors are free of recurrent valve thrombosis. One had a minor peripheral embolus. Prosthetic valve thrombosis is a serious condition. There are special problems related to diagnosis and treatment of these patients which we discuss, according to our experience of more than 4000 valvular replacements.