HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Renzulli, A. Articles by Cotrufo, M. Search for Related Content PubMed PubMed Citation Articles by Renzulli, A. Articles by Cotrufo, M.

European Journal of Cardio-Thoracic Surgery, Vol 6, 412-420, Copyright © 1992 by European Association for Cardio-thoracic Surgery

ARTICLES

Acute thrombosis of prosthetic valves: a multivariate analysis of the risk factors for a lifethreatening event

A Renzulli, L De Luca, A Caruso, R Verde, D Galzerano and M Cotrufo
Institute of Cardiac Surgery, V. Monaldi Hospital, University of Naples 1st Medical School, Italy.

In 3231 prosthetic valves implanted between January 1975 and November 1990, we observed 61 cases of prosthetic obstruction of biological origin with clinical and laboratory findings of severe functional impairment which required surgery as emergency treatment. The hospital mortality was 19.67% (12/61). The obstruction was due to a primary thrombosis in all 5 bioprostheses which were not anticoagulated and in 11/56 (19.64%) mechanical prostheses of which 3 were not anticoagulated and 4 were not properly anticoagulated. The obstruction was due to fibrous tissue overgrowth in the other 45 mechanical prostheses (80.35%) with secondary thrombosis in 34 cases (60.71%) and no thrombosis in 11 (19.64%); 71.11% of these prostheses were adequately anticoagulated. Of the 61 obstructed prostheses, 53 were mitral and 8 were aortic. No tricuspid obstruction was observed. A statistical assessment by multiple correspondence, cluster and chi square analysis was performed in two groups of patients with different models of mechanical mitral prostheses. The 5-year actuarial incidence of obstruction was 6.08%. Significant risk factors were: tilting disc prostheses, prostheses without pyrocarbon coating, large prostheses, tilting disc prostheses with a small orifice posteriorly oriented, atrial fibrillation, enlarged left atrium, time from implant greater than 4 years, age between 40 and 50 years. In our opinion, prosthetic obstruction may be referred to a primary thrombosis only in cases where it may be prevented by adequate anticoagulation. In most cases, the obstruction is produced by periprosthetic fibroblastic proliferation which may develop in spite of adequate anticoagulation in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				U. Dandekar, M. Kalkat, and C. Smallpeice Fatal early acute thrombosis of mechanical mitral prosthesis Interactive CardioVascular and Thoracic Surgery, August 1, 2006; 5(4): 460 - 461. [Abstract] [Full Text] [PDF]

				H. Teshima, N. Hayashida, H. Yano, M. Nishimi, E. Tayama, S. Fukunaga, H. Akashi, T. Kawara, and S. Aoyagi Obstruction of St Jude medical valves in the aortic position: histology and immunohistochemistry of pannus J. Thorac. Cardiovasc. Surg., August 1, 2003; 126(2): 401 - 407. [Abstract] [Full Text] [PDF]

				R. Roudaut, S. t. Lafitte, M.-F. Roudaut, C. Courtault, J.-M. Perron, C. Jais, X. Pillois, P. Coste, and A. DeMaria Fibrinolysis of mechanical prosthetic valve thrombosis: A single-center study of 127 cases J. Am. Coll. Cardiol., February 19, 2003; 41(4): 653 - 658. [Abstract] [Full Text] [PDF]

				T. Ohata, T. Sakakibara, H. Takano, and T. Ishizaka Acute Thrombotic Obstruction of Mitral Valve Prosthesis: Low Protein C Level Asian Cardiovasc Thorac Ann, June 1, 2002; 10(2): 165 - 166. [Abstract] [Full Text] [PDF]

				W.R. E. Jamieson, R. T. Miyagishima, G. L. Grunkemeier, E. Germann, C. Henderson, G. J. Fradet, L. H. Burr, and S. V. Lichtenstein Bileaflet mechanical prostheses performance in mitral position Eur. J. Cardiothorac. Surg., June 1, 1999; 15(6): 786 - 794. [Abstract] [Full Text] [PDF]

				S. P. Hoerstrup, G. Zund, A. Schoeberlein, Q. Ye, P. R. Vogt, and M. I. Turina Fluorescence activated cell sorting: A reliable method in tissue engineering of a bioprosthetic heart valve Ann. Thorac. Surg., November 1, 1998; 66(5): 1653 - 1657. [Abstract] [Full Text] [PDF]

				N. Vitale, A. Renzulli, L. Agozzino, A. Pollice, N. Tedesco, L. d. L. T. Schinosa, and M. Cotrufo Obstruction of Mechanical Mitral Prostheses: Analysis of Pathologic Findings Ann. Thorac. Surg., April 1, 1997; 63(4): 1101 - 1106. [Abstract] [Full Text]

				N. Vitale, L. de Luca, A. Renzulli, and M. Cotrufo Thrombolysis for Prosthetic Valve Thrombosis Ann. Thorac. Surg., April 1, 1995; 59(4): 1045 - 1045. [Full Text]