Mitral Valve Thrombectomy: A Novel and Safe Approach for Stuck Mitral Valve
Background: Objective: To retrospectively evaluate and compare the outcome of mitral valve thrombectomy (Group A) versus Redo mitral valve replacement (Group B) for acute mitral prosthetic valve thrombosis (PVT).
Methods: 104 patients underwent redo surgery for obstructive mitral PVT in our center from January 2016 to March 2018 were included. Patients having acute PVT of other valves were excluded. Pre-operative, peri-operative and post-operative parameters affecting the outcome with follow-up data were measured. Group A (n = 26) underwent mitral valve thrombectomy & group B (n = 78) were treated by redo mitral valve replacement (MVR). Diagnosis of prosthetic valve obstruction was made on the basis of history, clinical examination, echocardiography and fluoroscopy. Total cross clamp and CPB time, hemodynamic status, ionotropic support, ventilation time, intensive care, total hospital stay, morbidity and mortality were also recorded for comparison. Echocardiography was done before discharge.
Results: No statistical difference was found on the basis of gender, age, interval between initial MVR and redo operation, anticoagulation status, functional class, international normalized ratio, echocardiography and fluoroscopy. The mean CBP time & cross clamp time was significantly less in group A than group B. Similarly mean ventilation time, Ionotropic support, mean ICU stay and mean hospital stay in group A was significantly less than group B.
Conclusions: PVT is a dreaded complication after mechanical MVR with high mortality without timely and effective surgical intervention. Mitral valve thrombectomy being a less aggressive surgical technique is recommended because of better outcome in terms of morbidity and mortality.
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