[Analysis on the risk factors of intracardial thrombus after prosthetic valve replacement: a 1-year follow-up study]
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Published on: December 11, 2017
Ming-yan Wang1, Chang-qing Gao, Yao Wang
1Department of Cardiovascular Surgery, People's Liberation Army General Hospital, Beijing 100853, China.
Insights
Mitral position valve replacement, atrial fibrillation, and larger left atrium diameter increase intracardial thrombus risk after prosthetic valve replacement. Standardized anticoagulation is crucial for prevention.
Area of Science:
- Cardiovascular Surgery
- Thrombosis Research
- Prosthetic Valve Development
Context:
- Intracardial thrombus formation poses a significant risk following prosthetic valve replacement surgery.
- Understanding predictive factors is essential for optimizing patient outcomes and preventing thromboembolic events.
Purpose:
- To identify and analyze the key risk factors associated with intracardial thrombus development after prosthetic valve replacement.
Summary:
- Retrospective analysis of 29 patients revealed that mitral position valve replacement, atrial fibrillation, and preoperative left atrial diameter are significant predictors of intracardial thrombus.
- Bioprosthetic valve type and aspirin anticoagulation were identified in univariate analysis but not confirmed as independent risk factors in multivariate analysis.
Impact:
- Findings highlight the need for standardized anticoagulation protocols, particularly for bioprosthetic valves.
- Improved risk stratification can guide clinical decision-making and enhance patient management strategies post-surgery.
Objective:
To analysis the risk factors predicting intracardial thrombus after prosthetic valve replacement.
Methods:
The clinical data of 29 cases from January 2005 to April 2009 with intracardial thrombus after prosthetic valve replacement during a 1-year follow-up was retrospectively analyzed. There were 11 male and 18 female, aged from 12 to 70 years with a mean of 48 years. The risk factors of intracardial thrombus were examined by univariate and multivariate analysis.
Results:
Univariate analysis found that bioprosthetic valve replacement, anticoagulation using aspirin, valve replacement at mitral position, atrial fibrillation, preoperative and postoperative internal diameter of left atrium, postoperative fibrinogen were predict factors of intracardial thrombus after prosthetic valve replacement (P < 0.05). Logistic regression analysis showed valve replacement at mitral position (OR = 9.815, P < 0.05), atrial fibrillation (OR = 5.267, P < 0.05), preoperative internal diameter of left atrium (OR = 4.529, P < 0.05) were significant risk factors of intracardial thrombus after prosthetic valve replacement.
Conclusions:
Valve replacement at mitral position, atrial fibrillation, and preoperative internal diameter of left atrium are the correlated risk factors of intracardial thrombus after prosthetic valve replacement. Anticoagulation after prosthetic valve (especially bioprosthetic valve) replacement should be standardized to prevent intracardial thrombus formation.
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