• Prosthetic Heart Valve Thrombosis

    (Prosthetic Valve Thrombosis; PVT)


    Prosthetic heart valve thrombosis is a rare but serious complication of a heart valve replacement procedure . The complication occurs when a thrombus (blood clot) is attached to or near a prosthetic heart valve. This can obstruct blood flow or interfere with the function of the valve. This condition can be life-threatening. Seek medical attention immediately if you think you have prosthetic heart valve thrombosis.
    Heart Valves With Prosthetic Replacements
    BP00039 97870 1 heart valve.jpg
    Copyright © Nucleus Medical Media, Inc.


    Prosthetic heart valve thrombosis is thought to result from an interaction between components of blood and the prosthesis or turbulent blood flow in and around the prosthesis.

    Risk Factors

    The following factors may increase your chance of developing prosthetic heart valve thrombosis. If you have any of the following risk factors, tell your doctor:
    • Inadequate anticoagulant (blood thinning) therapy after a valve transplant
    • Prosthesis located at the mitral valve in the heart
    • Atrial fibrillation
    • Drugs (eg, contraceptives)
    • Cancerous tumors
    • Systemic diseases (eg, systemic lupus erythematosus , inflammation and damage to various body tissues, including joints, skin, kidneys, heart, lungs, blood vessels, and brain)
    • Reduced cardiac pumping (low ejection fraction)


    • Shortness of breath
    • Difficulty breathing while lying down
    • Waking at night short of breath
    • Swelling
    • Fatigue
    • Difficulty exercising
    • Chest pain, burning, or pressure
    • Nausea
    • Numbness
    • Loss of consciousness
    • Stroke
    • Transient ischemic attack
    • Absence or lessening of prosthetic noise


    Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include the following:
    • Echocardiogram —a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
    • Blood tests
    • Fluoroscopy—an x-ray technique


    Talk with your doctor about the best treatment plan for you. Treatment options include:


    The first line of therapy is usually thrombolysis, which uses medications to break up abnormal blood clots.

    Anticoagulation Therapy

    Anticoagulant medications are used to control clotting. Anticoagulation therapy may be used alone in people with small clots that are not obstructing the heart valve.

    Valve Replacement

    In some cases, surgery to replace the valve may be necessary.


    In people who have prosthetic heart valves, antithrombotic therapy (eg, warfarin and aspirin) is the best proven way to reduce the risk of prosthetic heart valve thrombosis.


    American Heart Association http://www.americanheart.org/

    National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/


    Canadian Heart Research Centre http://www.chrc.net/

    Heart and Stroke Foundation of Canada http://www.heartandstroke.ca/


    Prosthetic heart valve thrombosis. DynaMed website. Available at: http://dynamed101.epnet.com/Detail.aspx?id=165492 . Accessed February 27, 2007.

    Serpi M, Schmidt KG, Kreuz W, et al. Thrombolysis of prosthetic heart valve thrombosis using recombinant tissue plasminogen activator. Z Kardiol. 2001;90(3):191-196. Available at: http://www.ncbi.nlm.nih.gov/entrez/query.fcgicmd=Retrieve&db=PubMed&list%5Fuids=11315578&dopt=Abstract.

    Roudant R, Serri K, Lafitte S. Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations. Heart. 2007;93:137-142.

    Revision Information

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