MISCONCEPTIONS AND DIAGNOSTIC CHALLENGES IN BIOPROSTHETIC VALVE THROMBOSIS



Sorin V. Pislaru, M.D., Ph.D., Mayo Clinic, Rochester, Minnesota, USA

Bioprosthetic valve thrombosis (BPVT) is a rare, but potentially life-threatening complication. In a review of the Mayo Clinic experience we found that BPVT was systematically under-reported on TTE, and that most cases occurred late post-implantation. Furthermore, oral anticoagulation with vitamin K antagonists resulted in hemodynamic and clinical improvement with minimal risk, and should be considered first line therapy in hemodynamically stable patients. Echocardiographic criteria for improving BPVT diagnosis are proposed.