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Comprehensive collection of COVID-19 related prosthetic valve failure: a systematic review

Theresa K Trieu1, Kade Birkeland2, Asher Kimchi3

  • 1College of Medicine, California Northstate University, Elk Grove, CA, USA.

Journal of Thrombosis and Thrombolysis
|December 17, 2022
PubMed

Insights

COVID-19 infection is linked to prosthetic valve thrombosis (PVT) in heart valve replacement patients. Increased monitoring during infection is crucial for preventing PVT and prosthetic valve failure.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Hematology

Background:

  • The association between SARS-CoV-2 (COVID-19) infection and venous thromboembolism (VTE) is well-established, with increased inflammation contributing to hypercoagulability.
  • While thrombotic events are documented in COVID-19, prosthetic valve thrombosis (PVT) remains infrequently reported.
  • This review focuses on the critical intersection of COVID-19 and PVT in patients with cardiac valve prostheses.

Approach:

  • A systematic review was conducted to identify and analyze reported cases of PVT in patients with concurrent or recent COVID-19 infection.
  • Eight cases of COVID-19-related PVT were identified, detailing valve position (mitral/aortic) and prosthesis type (bioprosthetic/mechanical).
  • Analysis included patient adherence to anticoagulation and the timing of PVT relative to valve replacement surgery.

Key Points:

  • All eight reviewed cases demonstrated PVT in association with COVID-19 infection.
  • PVT occurred despite apparent adherence to anticoagulation in most cases, with some cases arising years after valve replacement.
  • Valve thrombosis represents a significant mechanism for prosthetic valve dysfunction and failure.

Conclusions:

  • COVID-19 infection poses a risk for PVT, necessitating heightened surveillance in the peri-infectious period for patients with prosthetic valves.
  • Understanding the relationship between COVID-19 and PVT is vital given the increasing population of valve replacement recipients and recurrent viral surges.
  • Exploring tailored antithrombotic strategies may enhance protection against PVT during COVID-19 infection.

Keywords:
Bioprosthetic valveCOVIDMechanical valveProsthetic valve thrombosisThrombosis

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