Early outcomes of Mitral Valve Thrombectomy for Obstructive Mechanical Prosthetic Valve Thrombosis

Background: Prosthetic heart valve thrombosis (PHVT) is a serious complication, particularly after mitral valve replacement. Obstructive PHVT, often leading to “stuck valve” syndrome, requires immediate intervention, either thrombolysis or surgery. This study investigated the early outcomes and 1-year functional status of patients undergoing mitral valve thrombectomy for obstructive PHVT. Methods: This was a prospective observational study enrolling 30 patients who underwent redo mitral valve thrombectomy for obstructive PHVT between June 2022 and December 2024. Patients with acute PHVT of the aortic valve, combined surgeries, or recurrence were excluded. Follow-up involved clinical assessment, functional status (New York Heart Association [NYHA] class), and trans-thoracic echocardiography at 6 months and 1 year, focusing on maintaining a therapeutic international normalized ratio (INR 2.5–3.5). Results: Among 30 patients, the mean age was 36.83 ± 6.98 years, with females comprising 53.3%. Mitral valve thrombectomy significantly improved hemodynamic parameters; survivors ( n = 26) demonstrated a successful reduction in mean gradients and a significant shift in median INR from 1.7 at admission to 2.9 at 1-year follow-up ( P < 0.0001). Chronic kidney disease was more frequently observed among nonsurvivors (13.34%) and severe preoperative hemodynamic collapse. At 1 year, all survivors remained clinically stable and reached NYHA Class I status, confirming that the procedure provides durable functional recovery when coupled with strict anticoagulation monitoring. Conclusion: Mitral valve thrombectomy is a feasible treatment strategy for obstructive PHVT, particularly in patients who fail thrombolysis. Maintaining strict therapeutic anticoagulation (INR 2.5–3.5) postsurgery is crucial for preventing recurrence, ensuring long-term symptomatic and functional stability.