ISSN 2149-2263 | E-ISSN 2149-2271
Lessons Learned From Intermittent Dysfunction of Mechanical Heart Valve [Anatol J Cardiol]
Anatol J Cardiol. 2022; 26(9): 725-732 | DOI: 10.5152/AnatolJCardiol.2022.1677

Lessons Learned From Intermittent Dysfunction of Mechanical Heart Valve

Semih Kalkan1, Ahmet Güner2, Macit Kalçık3, Mustafa Ozan Gürsoy4, Sabahattin Gündüz5, Emrah Bayam6, Mahmut Yesin7, Süleyman Karakoyun8, Mustafa Ferhat Keten6, Mehmet Özkan9
1Department of Cardiology, Erzurum Training and Research Hospital, Erzurum, Turkey
2Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
3Department of Cardiology, Faculty of Medicine, Hitit University, Çorum, Turkey
4Department of Cardiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
5Department of Cardiology, Bahçeşehir University, Medical Park Hospital, İstanbul, Turkey
6Department of Cardiology, Koşuyolu Kartal Training and Research Hospital, İstanbul, Turkey
7Department of Cardiology, Kars Kafkas University, Kars, Turkey
8Faculty of Health Sciences, Ardahan University, Ardahan, Turkey
9Department of Cardiology, Koşuyolu Kartal Training and Research Hospital, İstanbul, Turkey; Faculty of Health Sciences, Ardahan University, Ardahan, Turkey

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.

Keywords: Prosthetic, valve disease, dysfunction, echocardiography

Semih Kalkan, Ahmet Güner, Macit Kalçık, Mustafa Ozan Gürsoy, Sabahattin Gündüz, Emrah Bayam, Mahmut Yesin, Süleyman Karakoyun, Mustafa Ferhat Keten, Mehmet Özkan. Lessons Learned From Intermittent Dysfunction of Mechanical Heart Valve. Anatol J Cardiol. 2022; 26(9): 725-732

Corresponding Author: Semih Kalkan, Türkiye
Manuscript Language: English

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