Open AccessEarly Outcomes of Emergency Surgery for Left-Sided Mechanical Valve Thrombosis
Author(s) -
Hesham Saleh,
Mohamed Zaky Azzam,
Ahmed Ah Swailum,
Alaa Eldin Farouk
Publication year - 2021
Publication title -
the heart surgery forum/the heart surgery forum
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.255
H-Index - 38
eISSN - 1522-6662
pISSN - 1098-3511
DOI - 10.1532/hsf.4301
Subject(s) - medicine , thrombosis , emergency surgery , mechanical valve , cardiology , surgery
Background: Valve thrombosis is a potentially lethal complication of mechanical cardiac valves. We examined the clinical characteristics as well as the early outcomes of patients undergoing emergency surgery for left-sided mechanical valve thrombosis.Methods: Between January 2012 and May 2020, 104 consecutive patients were offered an emergency redo surgery for acute mechanical valve thrombosis. Ninety-seven of these patients were included in the current study.Results: The mean age was 34.2 ± 10.3 years. Most of the patients were females (61 patients), and 27 patients (27.8%) were pregnant. The mitral valve was the site of thrombosis in 81 patients. Inadequate anticoagulation was found in 60.8% of patients. The overall early mortality was 32.9% (32 patients) with an operative mortality of 25.7%. Outcomes in the pregnant subgroup tended to be worst with a maternal mortality in the range of 37%, and with fetal and neonatal survival as low as 33.3%.Conclusion: The overall mortality in cases of mechanical valve thrombosis warranting surgery remains high. Since inadequate anticoagulation seems to be one of the major precipitating factors, the current study highlights the need for improvements in anticoagulation practices. The use of tissue valves should also be contemplated more seriously in some younger patients, especially females expressing the desire for future pregnancies.