Prosthetic valve thrombosis in a tertiary cardiac centre
Journal Title: Nepalese Heart Journal - Year 2017, Vol 14, Issue 1
Abstract
Background and Aims: Prosthetic valve thrombosis remains a major complication of valve replacement surgeries in Nepal. A number of patients present with thrombotic complications mainly due to poor anticoagulation status with irregular INR checkup at the remote areas of Nepal. Thrombolysis is the preferred method in the management of stuck valve patients due to fnancial issues . We aimed to retrospectively study the clinical profle and management trends of stuck prosthetic valve Methods: : A one year retrospective data of 23 patients (Jan 2015 - Jan 2016) admitted with diagnosis of prosthetic valve thrombosis were studied. The demographic profle, clinical parameters and in hospital outcome were analysed. Results: Out of 23 patients, majority were female (52.2%) with the age group 13-49 years (mean = 35). Sixteen patients (69.6%) presented with INR value < 1.5 at admission. Twenty patients ( 86.9%) were thrombolysed with streptokinase while 3 patients ( 13.1 %) were subjected to treatment with tenecteplase . Valve thrombosis was most common at the mitral position 17 (73.9%) patients. In hospital mortality was seen in 5 ( 21.7%) patients and there were no major bleeding events or new stroke noted. Conclusion: Majority of patients with prosthetic valve thrombosis presented with a subtherapeutic INR value. Thrombolysis can be a useful option in the management of prosthetic valve thrombosis patients in a less resourceful country.
Authors and Affiliations
Anish Hirachan| Department of Cardiology , National Academy of Medical Sciences , Kathmandu, Madhu Roka| Department of Cardiology, Sahid Gangalal National Heart Centre , Bansbari , Kathmandu, Dipanker Prajapati| Department of Cardiology, Sahid Gangalal National Heart Centre , Bansbari , Kathmandu, Chandra Mani Adhikari| Department of Cardiology, Sahid Gangalal National Heart Centre , Bansbari , Kathmandu, Bishal K. C| Department of Cardiology , National Academy of Medical Sciences , Kathmandu, Manjila Basnet Khadka| Department of Cardiology, Sahid Gangalal National Heart Centre , Bansbari , Kathmandu, Arun Maskey| Department of Cardiology, Sahid Gangalal National Heart Centre , Bansbari , Kathmandu, Deewakar Sharma| Department of Cardiology, Sahid Gangalal National Heart Centre , Bansbari , Kathmandu
The Clinical and Electrophysiological Features in Patients with Wolff- Parkinson- White Syndrome
Background and Aims: Wolff-Parkinson-White Syndrome is a congenital anomaly with delta wave in electrocardiogram representing an accessory conducting pathway. The aim of the present study was to evaluate the characterist...
Penetrating Atherosclerotic Ulcer of Aorta: A Giant Lurking in the Dark
Penetrating atherosclerotic ulcer is one of the acute aortic conditions, associated with high morbidity and mortality. Management option is often debated between conservative vs. surgical, with different data supporting...
Pheochromocytoma Presenting As Acute Myocardial Infarction
Pheochromocytomas are rare neuro-endocrine tumors arising from chromaffn cells of the sympathetic nervous system.Pheochromocytomacan have diverse clinical presentations, which makes the diagnosis often diffcult. We pre...
Pattern of Heart Valve Involvement in Rheumatic Heart Disease
Rheumatic heart disease is the most important consequence of acute rheumatic fever. Both are common cardiovascular problems in Nepal. Echocardiographic detection of rheumatic heart disease is important to establish the...
Is he the culprit?
The peripartum cardiomyopathy (PPCM) generally occurs in the last trimester of pregnancy or within 6 months of delivery. The disease generally occurs in multparous female more than 30 years of age. The prognosis depends...