PMID- 21676679
OWN - NLM
STAT- MEDLINE
DCOM- 20120322
LR  - 20161125
IS  - 1522-6662 (Electronic)
IS  - 1098-3511 (Linking)
VI  - 14
IP  - 3
DP  - 2011 Jun
TI  - Sources of thromboembolism in patients with correctly functioning mechanical 
      valves: a single-center transesophageal echocardiographic study.
PG  - E149-56
LID - 10.1532/HSF98.20101048 [doi]
AB  - BACKGROUND: In patients with mechanical prostheses (MP), thromboembolism is one 
      of the most serious complications. The study aim was to assess the incidence of 
      sources of thromboembolism in patients with correctly functioning MP with and 
      without a history of thromboembolism. METHODS: Two hundred ninety-seven patients 
      with correctly functioning MP were enrolled in this single-center, 
      transesophageal echocardiographic (TEE), retrospective, observational study. Two 
      groups were analyzed: Group A, 183 patients with a history of thromboembolism, 
      and Group B, 114 patients with no history of thromboembolism. RESULTS: Definite 
      sources of thromboembolism were revealed in 59% of patients in Group A, and 
      sources of potential thromboembolism were revealed in 13% of patients in Group B 
      (P < .001). Multiple sources of thromboembolism were present in 9% of patients in 
      Group A and 1% of patients in Group B. Localization of sources of thromboembolism 
      included MP ring (59% and 53% of patients in Groups A and B, respectively); left 
      atrium/left atrium appendage (24%/21% and 13%/40% of patients in Groups A and B, 
      respectively); and aorta (12% and 13% of patients in Groups A and B, 
      respectively). Patients with multiple sources of thromboembolism were older (P < 
      .001) and in a higher New York Heart Association (NYHA) class (P = .004). 
      Patients with sources of thromboembolism in the aorta were older than the rest of 
      the group (P < .01). CONCLUSIONS: In patients with correctly functioning MP, 
      sources of thromboembolism are observed 4 times more often in case of the 
      positive history of thromboembolism. The most common source of thromboembolism is 
      thrombosis of MP ring. Age and heart failure predispose multiple sources of 
      thromboembolism. One might consider control TEE after mechanical valve 
      implantation, but only in selected group of patients without embolic events but 
      with a higher risk of thromboembolism.
FAU - Maciejewski, Marek
AU  - Maciejewski M
AD  - Clinic of Cardiology, Institute of Cardiology and Cardiac Surgery, Medical 
      University of Lodz, Poland.
FAU - Piestrzeniewicz, Katarzyna
AU  - Piestrzeniewicz K
FAU - Jaszewski, Ryszard
AU  - Jaszewski R
FAU - Bielecka-Dabrowa, Agata
AU  - Bielecka-Dabrowa A
FAU - Goch, Jan H
AU  - Goch JH
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Heart Surg Forum
JT  - The heart surgery forum
JID - 100891112
SB  - IM
MH  - Adult
MH  - Aged
MH  - Comorbidity
MH  - Echocardiography, Transesophageal/*statistics & numerical data
MH  - Female
MH  - Heart Valve Diseases/*epidemiology/*surgery
MH  - Heart Valve Prosthesis/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Poland/epidemiology
MH  - Postoperative Complications/*epidemiology
MH  - Prevalence
MH  - Prosthesis Failure
MH  - Risk Assessment
MH  - Risk Factors
MH  - Thromboembolism/*diagnostic imaging/*epidemiology
EDAT- 2011/06/17 06:00
MHDA- 2012/03/23 06:00
CRDT- 2011/06/17 06:00
PHST- 2011/06/17 06:00 [entrez]
PHST- 2011/06/17 06:00 [pubmed]
PHST- 2012/03/23 06:00 [medline]
AID - 0JHM541378H44154 [pii]
AID - 10.1532/HSF98.20101048 [doi]
PST - ppublish
SO  - Heart Surg Forum. 2011 Jun;14(3):E149-56. doi: 10.1532/HSF98.20101048.