پديد آورندگان :
Bassiri Hussein Ali نويسنده , Reshadati Najmeh نويسنده , Sadeghpour Anita نويسنده , Kiavar Majid نويسنده , Hashemi Jafar نويسنده
چكيده لاتين :
Background- The purpose of this study was to determine how frequently prosthetic valve nonobstructive
thrombosis is associated with prosthetic mitral and aortic valves and to assess their
correlation with the anticoagulant status and symptoms of patients.
Methods- From January 2006 to April 2007, all the patients with prosthetic heart valves who were
referred for clinically-indicated transesophageal echocardiography (TEE) were evaluated for
the presence of non-obstructive thrombosis. Clinical information was collected through patient
interviews. Non-obstructive thrombosis was defined as a distinct mass (more than 1 mm in
width and 2 - 15 mm in length) with abnormal echoes attached to the normally functioning
prosthesis and clearly seen throughout the cardiac cycle via two-dimensional, Doppler, and
cinefluoroscopy studies. Masses were classified according to their size as small (<5 mm),
moderate (5-10 mm), and large (>10 mm).
Results- The study recruited 102 consecutive patients (64 female) with a mean age of 51 پ}11.4
years with non-obstructive thrombosis. There were 132 prosthetic valves (PVs), of which 94
were prosthetic mitral valves (PMVs) and 38 were prosthetic aortic valves (PAVs). The mean
time between surgery and TEE examination (age of the prosthesis) was 12 پ} 7 years. INR
value was less than 1.5 in 50 (49%) cases, between 1.5 . 2.5 in 42 (41.2%) patients, and more
than 2.5 in 10 (9.8%). Additionally, 34 (33.3%) patients had recent systemic emboli, 32
(31.9%) had exacerbation of dyspnea, and 14 (13.7%) were asymptomatic.
Conclusions- Sub-therapeutic anticoagulation (INR values < 2.5), systemic emboli, and dyspnea
are the key factors for the detection of non-obstructive thrombosis. Moreover, TEE is
particularly useful when the thrombus is not visualized by TTE (Iranian Heart Journal 2009;
10 (2):20-24).