Background: The authors report their experience on the diagnosis, pathological findings and surgical treatment of prosthetic aortic valve thrombosis.
Methods: Between January 1976 and June 1998, 1289 mechanical prostheses were implanted in aortic position at our institution: a prosthetic obstruction was found in 12 cases. Thrombolysis was performed in two cases and as a result, pathological findings were not available and the patients were excluded from the study. Ten patients underwent surgical treatment.
Results: Thrombectomy was performed in one case and prosthetic replacement was done in 9 patients. One patient died postoperatively of low-output syndrome, the others were discharged and no recurrence of thrombosis has been observed at follow-up. Primary thrombosis was found in 6 cases, and pannus formation was observed in 4 patients. All patients with primary thrombosis had a history of poor anticoagulation. Patients with pannus formation had a tilting disc prosthesis.
Conclusions: Use of bileaflet prostheses and adequate anticoagulation can further lessen the incidence of this dreadful complication.