Prosthetic Valve Failure Treatment in India

A prosthetic valve failure is when an implanted valve in the heart is diseased or damaged. There are several reasons why a prosthetic valve failure can happen. Any heart valve can be diseased, and the damaged prosthetic valve may not open and close.

Etiology of Prosthetic Valve Failure

• Thrombosis – Thrombosis occurs due to inadequate anticoagulation, low cardiac function, and atrial fibrillation.
• Pannus formation – It is the result of an overgrowth of fibrous tissue that invades the valve orifice and may lead to a non-immune inflammatory reaction. Pannus formation can also be one of the reasons for the re-operation of the valve.
• Infection – Some lifestyle habits and diseases such as diabetes, metabolic syndrome, smoking, and others may lead to prosthetic valve failure.
• Calcification – Calcium builds up on the implanted tissue leading it to be hardened, causing prosthetic heart failure.

Two of the most common causes of prosthetic valve failure are pannus formation and thrombosis. These causes have been identified in more than 80% of patients with prosthetic valve failure.

Prosthetic Valve Failure Symptoms

Some of the common symptoms observed in prosthetic valve failure are as follows:

• Muffled mechanical heart sounds.
• Dyspnea.
• New murmur.
• Cardiogenic shock or heart failure.
• If the thrombosis is on the right side of the heart, it can cause right-sided heart failure.
• Swelling of legs.
• Pulmonary congestion.
• Swelling in the abdomen.

The symptoms can be acute or progressive depending on the rate or degree of the stenosis. Additionally, a prosthetic heart failure can also lead to transient ischemic stroke or pulmonary embolism if not treated on time. Thus, it is advisable to immediately seek professional medical help if you observe or suspect any of the above-mentioned signs and symptoms of prosthetic valve failure.

Prosthetic Valve Failure Diagnosis and Tests

The doctor will conduct a physical examination and listen to the heart murmur. In addition, the doctor may prescribe several tests before diagnosing the condition. Some of the tests prescribed by the doctors are as follows:

Echocardiography

This test helps assess the structure of the heart, the heart valves and the blood flow through the heart.

Cardiac MRI

An MRI uses radio waves and magnetic fields to create detailed images of the heart.

Cardiac Catheterization

This test gives the doctor a detailed picture of the heart arteries and how it functions.

Chest X-ray

A chest X-ray can help the doctor determine whether the heart has enlarged.

Electrocardiogram (ECG)

An ECG detects the enlarged chambers of the heart, heart disease and abnormal heart rhythms.

Stress Tests

It helps measure activity tolerance and monitor the heart’s response to any physical exertion.

Prosthetic Valve Failure Treatment

The treatment of prosthetic valve failure would depend on the symptoms, severity, and condition of the patient. The treatment options for prosthetic valve failure are as follows:

A mechanical valve failure or obstruction caused due to pannus formation requires heart surgery. This surgery would help remove the pannus and replace the damaged valve.

Thrombolytic therapy followed by Intravenous heparin is recommended for the treatment of mechanical valve thrombosis. Surgery is considered if heparin and thrombolytic therapy fails. Surgery may involve either removal of thrombus or if not possible re-replacement of the mechanical valve. But 99% times thrombus can be managed conservatively by thrombolytic agents without the need of surgery.

In addition to the above surgery options, the doctor could also recommend a few lifestyle changes such as:

• Maintaining the required dose of anti-coagulation
• Eating healthy and maintaining a balanced diet.
• Maintain healthy body weight.
• Manage your stress levels.
• Regular physical activity.
• Avoid consumption of tobacco.

Prosthetic valve repair is increasing among the geriatric population. Prosthetic valve thrombosis is a serious complication of valve replacement. The rising morbidity and mortality associated with this condition lead to rapid diagnostic evaluation.

The doctors may recommend various tests for the diagnosis of prosthetic valve failure along with physical examination. Also, healthy lifestyle changes, taking regular prescribed medication, and using blood thinners to reduce the risk of blood clots are the other treatment options recommended by doctors for patients diagnosed with prosthetic heart valve failure.