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Prosthetic valve thrombosis: predisposition and diagnosis

C. Piper1, D. Hering and D. Horstkotte

Department of Cardiology, Heart Center North Rhine-Westphalia, University Hospital of the Ruhr University of Bochum, Bad Oeynhausen, Germany

1 Correspondence: Comelia Piper, MD, Heart Center North Rhine-Westphalia, Department of Cardiology, Georgstrasse 11, D-32545 Bad Oeynhausen, Germany

Abstract

Prosthetic valve thrombosis (PVT) is an obstruction of a prosthesis by non-infective thrombotic material. The interaction of a variety of prosthesis- and patient-related factors account for risk for PVT. The typical clinical finding in PVT is diminution of occluder clicks, which may be detected using sound spectroscopy. Fluoroscopy facilitates prompt and reliable assessment of occluder movements. Interpretation of echocardiographic findings is not so simple. Echo-Doppler derived gradients that are twice as high as those found in ‘normal’ prostheses are suspicious and indicate PVT. Early diagnosis and prompt therapeutic intervention are required for successful management of PVT.

Key Words: Anticoagulation • fluoroscopy • hypercoagulability • prosthetic valve thrombosis • sound spectroscopy

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