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Thromboembolism in patients with advanced mitral valve prolapse
B Davidsen1, H Egeblad, A Pietersen
1Medical Department B, Rigshospitalet, Copenhagen, Denmark.
Journal of Internal Medicine
|December 1, 1989
Summary
Thromboembolism is uncommon in severe mitral valve prolapse (MVP). However, patients face a significant risk of systemic embolism (SE) as their condition worsens, often requiring surgery.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Thromboembolism in mitral valve prolapse (MVP) is theorized to stem from valve recesses and endothelial damage.
- This pathology is presumed to be more prevalent in advanced MVP cases requiring surgical intervention.
Purpose of the Study:
- To investigate the prevalence of perivalvular thrombi and systemic arterial embolism (SE) in patients with MVP and severe regurgitation before surgery.
Main Methods:
- Analysis of 21 consecutive patients with MVP and severe valve regurgitation undergoing open-heart surgery.
- Assessment for perivalvular and left atrial thrombi during surgery.
- Review of pre-operative systemic arterial embolism (SE) episodes.
Main Results:
- No perivalvular or left atrial thrombi were detected during open-heart surgery.
- Three patients (14%) experienced SE within three months prior to surgery, one despite anticoagulation.
- Systemic embolism (SE) occurred in a notable percentage of patients with advanced MVP.
Conclusions:
- Persistent thrombi are infrequent in mitral valve prolapse (MVP) with severe regurgitation.
- Patients with advanced MVP necessitating valve surgery face a substantial risk of systemic embolism (SE).