Mechanical valve obstruction : Re-replace or not

Kassem, Ehab

doi:10.21608/zumj.2022.117946.2459

Mechanical valve obstruction : Re-replace or not

Document Type : Original Article

Author

ehab kassem

elmodeer street 319

10.21608/zumj.2022.117946.2459

Abstract

Background
Failure of mechanical prothesis post mechanical valve replacement is dreadful complications Pannus and thrombosis are common causes of dysfunction. Different strategic plan for management but current approach still need more evidence
Methods
Retrospective study analysis data of patients operated secondary to MVO from July 2014 to dec 2019. Preoperative , operative data and post operative are collected and analyzed
Results
27 patients were operated secondary to MVO, Mean age was 31±12 yes . Majority of patients were female 15 (55.5%) most of patient in NYHA class 111 . TTE data persevered EF 50±11. MVO different according to obstructed valve Mitral valve thrombosis 15 patients with thrombus , 5 of them thrombus and pannus . In aortic valve 12 pannus . 3 of them with thrombus . The commonest preoperative rhythm is Sinus rhythm in 17 while AF in 10 patients . mean bypass time is 117±11 min while aortic cross clamp is 99±12 min. Mitral valve replacement in 12 patients ,valve thrombectomy in 5 patients. In Aortic valve 9 replacement , 3 excision of the pannus .
Conclusions
MVO is serious and life threatening complications. Urgent intervention is the clue .Thrombolysis has limited role and restricted indications and should directed to critically ill and high risk surgery while Open thrombectomy and pannus excision has early and mid term outcome but still lack long term outcome more evidence still needed . surgery is the definitive treatment with documented long term outcome.

Keywords