Editorial commentary: Cutting the Gordian knot of right-sided prosthetic valve thrombosis

J Card Surg. 2022 Apr;37(4):865-867. doi: 10.1111/jocs.16210. Epub 2022 Jan 7.

Abstract

With limited data available for the tricuspid valve, there are no stringent recommendations in the current guidelines (ESC 2021). Valve replacement for the right-sided heart is inherently problematic and bears the potential for complications - including prosthetic valve thrombosis (PVT). The purpose of this editorial is to review the key features of this clinical scenario and to outline the essential aspects for optimized patient management and improved outcome. Depending on the clinical presentation of PVT, either immediate surgery, thrombolysis, or anticoagulation may be considered - with the sole intensification of anticoagulation likely being the most inferior. Given the high risk of re-thrombosis, a dedicated follow-up program is essential to identify complications early and offer adequate treatment.

Keywords: cardiac surgery; prosthetic valve thrombosis; thrombosis; tricuspid valve regurgitation; tricuspid valve replacement.

MeSH terms

  • Heart Valve Diseases* / complications
  • Heart Valve Prosthesis* / adverse effects
  • Humans
  • Thrombolytic Therapy / adverse effects
  • Thrombosis* / drug therapy
  • Tricuspid Valve / surgery