The Anatolian Journal of Cardiology
Original Investigation

Lessons Learned From Intermittent Dysfunction of Mechanical Heart Valve

1.

Department of Cardiology, Erzurum Training and Research Hospital, Erzurum, Turkey

2.

Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey

3.

Department of Cardiology, Faculty of Medicine, Hitit University, Çorum, Turkey

4.

Department of Cardiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey

5.

Department of Cardiology, Bahçeşehir University, Medical Park Hospital, İstanbul, Turkey

6.

Department of Cardiology, Koşuyolu Kartal Training and Research Hospital, İstanbul, Turkey

7.

Department of Cardiology, Kars Kafkas University, Kars, Turkey

8.

Faculty of Health Sciences, Ardahan University, Ardahan, Turkey

Anatol J Cardiol 2022; 26: 725-732
DOI: 10.5152/AnatolJCardiol.2022.1677
Read: 108 Downloads: 34 Published: 01 September 2022

Background: Intermittent malfunction is a rare but potentially serious complication of prosthetic heart valve replacement. This study aimed to describe the clinical features and etiologic causes of patients with intermittent mechanical prosthetic heart valve dysfunction.

Methods: Between 2010 and 2021, 16 patients who were evaluated in the echocardiography laboratory of Koşuyolu Training and Research Hospital with the diagnosis of intermittent malfunction of prosthetic valves were included in the study.

Results: The evaluated patients consisted of 12 bi-leaflet mitral valve replacements and 2 mono-leaflet mitral valve replacements. The underlying causes of intermittent malfunction were classified as follows: residual chord (n=4), obstructive thrombus (n=2), non-obstructive thrombus (n=2), vegetation (n=2), pannus and obstructive thrombus coexistence (n=1), and solely pannus (n=1). One of the patients with mono-leaflet mitral valve replacements had pannus and obstructive thrombus. In the other patient with mono-leaflet mitral valve replacement, a stuck valve was observed in 1 of 12 beats secondary to arrhythmia. There were also 2 patients with aortic valve replacements. One patient had moderate aortic regurgitation due to prominent calcification and the other had moderate obstruction due to pannus. In the patient with pannus, a stuck leaflet was observed in 1 of 6 beats and moderate aortic regurgitation arose in 1 of 2 beats in the patient with calcification.

Conclusions: The intermittent stuck valve may have catastrophic outcomes. When making a treatment decision in these patients, assessing the degree of regurgitation or stenosis is essential. In particular, the frequency of entrapment should be taken into consideration when deciding the optimal therapy for intermittent prosthetic heart valve dysfunction.

Cite this article as: Kalkan S, Güner A, Kalçık M, et al. Lessons learned from intermittent dysfunction of mechanical heart valve. Anatol J Cardiol. 2022;26(9):725-732.

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ISSN 2149-2263 EISSN 2149-2271