Complications of Prosthetic Heart Valves

Presentation created by Prashant Chettri

Roll no: 24
 Introduction
• Early mortality rate has remained stable for more than
10 years.
• Mechanical valves appear to be a better option for some
patients.
• For young adults and patients with end-stage renal
disease because of the more rapid onset of structural
dysfunction of tissue valves.
• Unfavourable complications can occur after valve surgery.
Thromboembolism and bleeding complications
• Related to the use of warfarin anticoagulation therapy.
• Other causes: Intrinsic coagulation factors, intestinal
lesions, atrial enlargement, arrhythmias such as atrial
fibrillation.
• Risk factors: Preoperative history of cerebrovascular
events.
• Associated with high mortality and morbidity rates.
 Endocarditis

• Occurrence rate is approximately 0.5 % per patient-year.

• Early PVE , occurring <60 days from valve surgery, usually
results from contaminated surgical devices or a postoperative
wound infection, common bacteria are staph epedermidis,
staph aureus, and gram negative bacteria.
 Endocarditis
Risk factors for PVE are;

• -multiple valves

• -antecedents native valve endocarditis

Signs and symptoms are similar to those in native valve endocarditis.

Fever in a patients with a PV should be considered endocarditis until
proved otherwise .
 Structural Valve failure

• Structural valve failure is essentially confined to bio

prosthetic valves with one historical exception:

The Bjork-Shiley single tilting disk was withdrawn from use

in 1986 after reports of strut fracture.
 Structural Valve failure
Strut Fractures in Bjork-Shiley Valve (Ref 1)
 Non-Structural Dysfunction
• Includes paravalvular leaks without apparent endocarditis, cusp
entrapment by a pannus or other causes.
• 0.4–1.2 % per patient-year among recent mechanical heart valves.
Caused by:
• Technical errors
• Latent prosthetic endocarditis or annular calcification.
Clinical signs:
• Stenosis
• Echocardiogram*
 References
• Misawa Y. Valve-related complications after mechanical heart
valve implantation. Surgery today. 2015 Oct 1;45(10):1205-9.
• Rambod E, Isaacian M, inventors; BIOQUANTETICS Inc,
assignee. Non-invasive technique for identification of
structural integrity of Bjork Shiley convexo-concave
mechanical heart valves. United States patent US 8,109,876.
2012 Feb 7.
Thank you.