Prosthetic Mechanical Aortic Valve Thrombosis

Abstract

A man in his 60s with a history of metastatic prostate carcinoma, calcified bicuspid aortic stenosis, and aortic valve replacement 17 years ago presented to the emergency department with increasing shortness of breath. An outpatient cardiac electrocardiogram-gated computed tomography (CT) showed normal coronary arteries with a small, irregular perivalvular mass at the leaflet hinge point and reduced leaflet mobility, suggestive of obstructive valve thrombosis (Figure , A). Acute thrombolytic therapy was administered without any complications. Follow-up cardiac CT 3 days later showed normal leaf-let motion and resolution of the thrombus (Figure , B). The patient was discharged with an adjusted anticoagulation regimen.Prosthetic valve thrombosis is a serious complication of valvular replacement associated with significant morbidity and mortality and requiring rapid diagnostic and appropriately timed intervention. Although prosthetic valve thrombosis can be treated with urgent surgical revision, thrombolysis is a valid option. Cardiac CT may provide complementary diagnostic information of valve pathology. [1][2][3]

Chondroitin Sulfate Derivative Cross-Linking of Decellularized Heart Valve for the Improvement of Mechanical Properties, Hemocompatibility, and Endothelialization

“…Valvular heart disease is exhibiting a persistent rise in its prevalence due to the aging population and is going to be an escalating burden of cardiovascular disease globally. , Surgical valve replacement remains the primary treatment modality . The main point of contention in selecting optimal prosthetic valves is between mechanical and biological prosthetic valves, given the absence of a perfect valve substitute thus far. − The tissue-engineered heart valve (TEHV) presents a promising solution to overcome the challenge of long-term anticoagulation in mechanical prosthetic valves and the structural deterioration observed in glutaraldehyde-fixed bioprosthetic valves with a limited lifespan of 10–15 years. − Additionally, TEHV may represent an ideal valve substitute for pediatric patients due to its inherent bioactivity, remodeling potential, and self-repair capabilities with lifelong functionality …”