Why the study?
Does surgical thrombectomy and debridement improve surgical outcomes compared to re-replacement in patients with obstructed mechanical valve prosthesis?
Does surgical thrombectomy and debridement improve surgical outcomes compared to re-replacement in patients with obstructed mechanical valve prosthesis?
Surgical thrombectomy and debridement may be a safe and rapid alternative to re-replacement for obstructed mechanical heart valves.
Objective: Valve thrombosis defined as any thrombus not caused by infection attached to or near an operated valve that occludes part of the blood flow path and interferes with valve function. Treatment modalities are thrombolytic therapy, surgical thrombectomy and debridement, or re-replacement. The aim of this study is to review our experience in surgical thrombectomy and debridement for obstructed mechanical valve prosthesis, and the impact of the procedure on the outcome in comparison to re-replacement; Methods: The study was conducted retrospectively between 1995 to 2012 in Department of Cardiothoracic surgery, cardiology and internal medicine, Zagazig University Hospital. 92 patients with stuck valve were divided into two groups. Group (A): 54 patients with re replacement and Group (B): 38 patients treated by thrombectomy and debridement; Results: 92 patients with stuck valves the mean age was 38.4(±9.2), 68 male and 85 female in both groups. The large numbers of cases were mitral valve 35 (64.8%) patients in group A and 22 (57.9%) patients in group B, aortic malfunction in group A was 11 (20.4%)patients and 9 (23.7%) cases in group B, double valve malfunction was rare represent 8 (14.8%) and 7 (18.4%)cases in group A and group B respectively; Conclusion: We conclude that thrombectomy and debridement for malfunctioning mechanical valve is a safe, easy and rapid procedure to perform in some cases to avoid the risk of re replacement.
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Brik et al. (2012) studied this question.
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