CLINICAL PROFILE AND OUTCOME OF PROSTHETIC VALVE THROMBOSIS PATIENTS TREATED WITH THROMBOLYSIS

Abstract

Background: Prosthetic valve thrombosis (PVT) is a major and life-threatening complication of
post-valve replacement surgeries attributable mainly to inadequate anticoagulation. We aim to study the clinical profile and outcome after thrombolysis of patients with prosthetic valve
thrombosis.
Methods: This is a prospective, observational, single-center study carried out between January
2021 & January 2023 at a tertiary care center in India. A total of 86 patients who underwent
thrombolysis for PVT were included in the study. Clinical profile and in-hospital outcomes were collected using a pre-tested, semi-structured questionnaire.
Results: The mean age of the patients was 47.2 ± 11.2 years, predominantly females (58;
67.5%). Approximately one in four patients had AF (25.5%). The majority (50; 58.1%) did not
have PT/INR in the therapeutic range (<2). Only 40 (46.5%) patients were compliant with
anticoagulation. Mitral prosthesis was most commonly involved (59.3%). The majority of
patients (41; 47.6 %) presented after five years of surgery. Complete recovery after thrombolysis was achieved in 72(83.7%) patients. Mortality was noted in 8 patients (9.3%).
Conclusions: Based on the study findings, Poor drug compliance and sub-therapeutic INR still
remain major correctable contributing factors for PVT. Thrombolysis has a high success rate,
especially in patients with the first episode of PVT post-surgery, and may be considered as a first-line therapy where immediate surgical options are unavailable, especially in developing
countries like India