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Published on: February 11, 2022
Redo surgery outcomes for obstructed replaced valve: a single-center experience
Majed Tolah1,2, Ibraheem H Alharbi1,2, Hasan I Sandogji1,2
1Madina Cardiac Center, Madinah, Saudi Arabia.
Summary
Obstructive prosthetic valve thrombosis, often linked to poor anticoagulation, requires careful management. Direct surgery offers a favorable prognosis with a 7.7% 30-day mortality, potentially better than failed thrombolysis.
Area of Science:
- Cardiology
- Cardiac Surgery
- Thrombosis
Background:
- Obstructive prosthetic valve thrombosis is a serious complication with high morbidity and mortality.
- Understanding perioperative factors is crucial for effective interventions.
Purpose of the Study:
- To evaluate outcomes of surgical management for obstructive prosthetic valve thrombosis.
- To identify perioperative variables associated with poor prognosis.
Main Methods:
- Retrospective analysis of 39 patients undergoing redo surgery for obstructive prosthetic valve.
- Analysis of preoperative, intraoperative, and postoperative factors influencing outcomes.
Main Results:
- Mechanical valves in the mitral position were most commonly affected by thrombosis (>1 cm thrombus in 69.2%).
- Suboptimal INR (<2) was noted in 64.1% of patients.
- Major complications included respiratory failure (15.4%) and dysrhythmias (51.3%), with 30-day mortality at 7.7%.
Conclusions:
- Prosthetic valve thrombosis is often associated with suboptimal anticoagulant therapy.
- Redo valve replacement has a favorable prognosis (7.7% 30-day mortality).
- Direct surgical intervention may be safer and more effective than prior fibrinolysis for prosthetic valve thrombosis.
