Clinical profile of patients with prosthetic heart valve thrombosis undergoing fibrinolytic therapy and NYHA class as a predictor of outcome

Mehrdad Jafari Fesharaki; Mohammad Parsa Mahjoob; Naser Kachoeian; Vahid Eslami

doi:10.5812/intjcardiovascpract-131480

International Journal of Cardiovascular Practice

Current Issue All Issues In Press Accepted Manuscripts Search

Journal Information Editors & Boards Indexing and Listing Sources Journal Metrics Open Peer Review (OPR)Publication Ethics and Malpractice Statement Reviewer and AE Registration Form Support Contact Us

Authors Guide Submit Manuscript

Image Credit:Int J Cardiovasc Pract

Clinical profile of patients with prosthetic heart valve thrombosis undergoing fibrinolytic therapy and NYHA class as a predictor of outcome

Author(s):

Mehrdad Jafari Fesharaki

^1,*,

Mohammad Parsa Mahjoob²,

Naser Kachoeian³,

Vahid Eslami⁴

1Department of Cardiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2Prevention of Cardiovascular Disease Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3Department of Cardiovascular Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

International Journal of Cardiovascular Practice:Vol. 5, issue 2; e131480

Published online:Oct 30, 2020

Article type:Research Article

Received:Mar 25, 2020

Accepted:Sep 18, 2020

How to Cite:Jafari Fesharaki M, Mahjoob MP, Kachoeian N, Eslami V. Clinical profile of patients with prosthetic heart valve thrombosis undergoing fibrinolytic therapy and NYHA class as a predictor of outcome. Int J Cardiovasc Pract. 2020;5(2):e131480. doi:

Abstract

Introduction: Prosthetic heart valve thrombosis (PHVT) is a major complication in patients with mechanical prosthetic heart valve which occurs primarily due to ineffective anticoagulation. This study aimed to evaluate the clinical profile of the patients presenting with PHVT undergoing fibrinolytic therapy and analyzing patients with respect to New York Heart Association (NYHA) functional class on presentation and its association with outcome of fibrinolytic therapy.

Methods: This was prospective, observational study conducted from June, 2016 to April, 2018. Total 133 patients with prosthetic heart valve thrombosis were included. Routine blood investigations included complete hemogram, liver and renal function tests. Prothrombin time with INR was done on admission. The diagnosis of PHVT was assessed by cine-fluoroscopy (CF) and/or echocardiography (transthoracic/transesophageal). Follow-up at 6 months was scheduled for all patients.

Results: All patients received fibrinolytic therapy in which 108 (81.2%) were treated with streptokinase and 25 (18.8%) were treated with urokinase. On presentation, 48.9% patients were in NYHA class III, 41.4% in NYHA class IV and 9.77% in NYHA class II. Fibrinolytic therapy was successful in 105 patients (78.9%) and it failed in 28 patients (21.1%). Mortality in NYHA class II was 0%, NYHA class III was 4.6% and in NYHA class IV was 23.6%. During 6 months follow up prosthetic heart valve thrombosis recurred in 12 (11.43%) patients.

Conclusion: From our single center experience, fibrinolytic therapy is effective first line therapy for prosthetic heart valve thrombosis and NYHA functional class on presentation can predict the outcome of fibrinolytic therapy.

Keywords

NYHA Class

Prosthetic Heart Valve

Thrombosis

Fibrinolytic Therapy

Fulltext

Full-text is available in the PDF file.

Import into EndNote Import into BibTex

Share on

Comments

Number of Comments:0

Cited by

Scopus by DOI: 0
Last Update: 2 weeks ago
Scopus by Title: 0
Last Update: 2 weeks ago
Scopus by Title (Ref): 0
Last Update: 2 weeks ago
CrossRef: 0
Last Update: 4 days ago

Metrics

Ordering Reprints

Articles are published under the Creative Commons license stated on each article. No permission or royalty fee is required for uses permitted by that license. CCC handles optional bulk and customized reprint orders. Any quotation covers production and delivery services only, not copyright permission. > Request Reprints from CCC

Search Relations

Author(s):

Mehrdad Jafari Fesharaki:[PubMed][Scholar]
Mohammad Parsa Mahjoob:[PubMed][Scholar]
Naser Kachoeian:[PubMed][Scholar]
Vahid Eslami:[PubMed][Scholar]

Outlines

Clinical profile of patients with prosthetic heart valve thrombosis undergoing fibrinolytic therapy and NYHA class as a predictor of outcome

Abstract

Fulltext

Last Update: 2 weeks ago

Last Update: 2 weeks ago

Last Update: 2 weeks ago

Last Update: 4 days ago