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Characteristic localization patterns of thrombus on various brands of bileaflet mitral mechanical heart valves as assessed by three-dimensional transesophageal echocardiography and their relationship with thromboembolism
- Source :
- The international journal of cardiovascular imaging. 37(9)
- Publication Year :
- 2021
-
Abstract
- Three-dimensional transesophageal echocardiography (3D-TEE) provides detailed images of prosthetic valve thrombosis (PVT). However, data regarding PVT localization patterns based on 3D-TEE and their association with clinical findings among various bileaflet mitral prosthetic valve brands is lacking. The locations of thrombi were classified into 4 groups according to hinge and annulus involvement based on 3D-TEE: ring-like PVT involving entire mitral annulus (type-1), PVT involving peri-hinge(s) region and extends through some part of the annulus (type-2), PVT involving mitral annulus without involving hinge(s) region (type-3), and PVT involving only (peri)hinge(s) area (type-4). This study was conducted in 265 patients (male: 71, mean age: 46.3 +/- 12.7 years) with mitral PVT, including 150 St Jude Medical (SJM), 65 Carbomedics, 29 Medtronic ATS open-pivot, and 21 Sorin bileaflet mechanical valves. There was a significant difference in most common PVT localization patterns between different prosthetic valves (type-1 for Carbomedics and Sorin; type-2 for SJM and type-3 for ATS valves; p < 0.001). Additionally, PVT involving only (peri)hinge region(s) (type-4) was mostly observed in patients with SJM valves (18%). (Peri)hinge(s) area involvement was observed in the majority of study patients (78.1%). In patients who presented with thromboembolism, the most common PVT localization pattern was type-1 (53%). Increased age, low international normalized ratio on admission, PVT with a mobile part > 2 mm, type-1 and type-4 PVT were associated with thromboembolic events. In conclusion, thrombus can be displayed in distinct locations in several types of bileaflet mechanical valves due to different design, hinge and pivot mechanisms, which can be complicated with thromboembolic events. WOS:000638473800001 2-s2.0-85104240753 PubMed: 33835319
- Subjects :
- Male
medicine.medical_specialty
030204 cardiovascular system & hematology
Prosthesis Design
Mechanical heart
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Mitral valve
Internal medicine
Thromboembolism
medicine
Humans
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Mitral annulus
Thrombus
Prosthetic Valve Thrombosis
Cardiac imaging
business.industry
Significant difference
Mean age
Thrombosis
Middle Aged
medicine.disease
Two-dimensional Transesophageal Echocardiography
Three-dimensional Transesophageal Echocardiography
medicine.anatomical_structure
Heart Valve Prosthesis
cardiovascular system
Cardiology
Mitral Valve
Cardiology and Cardiovascular Medicine
business
human activities
Echocardiography, Transesophageal
Subjects
Details
- ISSN :
- 18758312
- Volume :
- 37
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- The international journal of cardiovascular imaging
- Accession number :
- edsair.doi.dedup.....6c30f412a61395e98e55f9fb74ea45cb