Prosthetic heart valve thrombosis is a rare, but serious complication of a heart valve replacement procedure. A blood clot called a thrombus is attached to or near a prosthetic heart valve. This can obstruct blood flow or interfere with the function of the valve.
Prosthetic heart valve thrombosis is a medical emergency.
Heart Valves With Prosthetic Replacements
Prosthetic heart valve thrombosis is thought to result from an interaction between components of blood and the prosthesis, or blood flow in and around the prosthesis.
Factors that may increase your chances of prosthetic heart valve thrombosis include:
- Inadequate anticoagulant/blood thinning therapy after a valve transplant
- Prosthesis located at the mitral valve in the heart
- Atrial fibrillation
- Certain medicines
- Cancerous tumors
- Systemic diseases such as systemic lupus erythematosus, or inflammation and damage to various body tissues, including joints, skin, kidneys, heart, lungs, blood vessels, and brain
- Reduced cardiac pumping—possibly from heart failure
Prosthetic heart valve thrombosis may cause:
- Shortness of breath
- Difficulty breathing while lying down
- Difficulty exercising
- Chest pain, burning, or pressure
- Loss of consciousness
Your doctor will ask about your symptoms and medical history. A physical exam may be done.
Images evaluate your heart and surrounding structures. These may include:
Your bodily fluids may need to be tested. This can be done with blood tests.
Talk with your doctor about the best treatment plan for you. Treatment options include:
The first line of therapy is usually thrombolysis, which are medicines that break up abnormal blood clots.
Anticoagulant medicines are used to control clotting. Anticoagulation therapy may be used alone in people with small clots that are not obstructing the heart valve.
In some cases, surgery to replace the valve may be necessary.
In people who have prosthetic heart valves, antithrombotic therapy is the best proven way to reduce your chance of prosthetic heart valve thrombosis.
American Heart Association http://www.heart.org
National Heart, Lung, and Blood Institute https://www.nhlbi.nih.gov
Canadian Heart Research Centre http://www.chrc.net
Heart and Stroke Foundation of Canada http://www.heartandstroke.ca
Anticoagulation overview. EBSCO DynaMed website. Available at: https://www.dynamed.com/drug-review/anticoagulation-overview . Updated August 14, 2017. Accessed September 15, 2017.
Heart valve surgery. Mount Sinai website. Available at: http://www.mountsinai.org/health-library/surgery/heart-valve-surgery. Accessed September 15, 2017.
Prosthetic heart valve dysfunction. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/prosthetic-heart-valve-dysfunction . Updated May 31, 2017. Accessed September 15, 2017.
Roudaut R, Serri K, Lafitte S. Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations. Heart. 2007;93(1):137-142.
- Reviewer: EBSCO Medical Review Board Michael J. Fucci, DO, FACC
- Review Date: 09/2018
- Update Date: 07/22/2020