PMID- 38503347
OWN - NLM
STAT- MEDLINE
DCOM- 20240408
LR  - 20240425
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 404
DP  - 2024 Jun 1
TI  - Management of prosthetic valve thrombosis with unfractionated heparin.
PG  - 131968
LID - S0167-5273(24)00518-7 [pii]
LID - 10.1016/j.ijcard.2024.131968 [doi]
AB  - BACKGROUND: Prosthetic valve thrombosis (PVT) is a severe and life-threatening 
      complication. Surgery and thrombolytic therapy (TT) carry a high risk, and in 
      several circumstances, optimal anticoagulation with unfractionated heparin (UFH) 
      infusion may be an alternative treatment. This study aimed to assess the results 
      of UFH in patients diagnosed with both obstructive and non-obstructive PVT. 
      METHODS: This observational retrospective study enrolled patients who had 
      contraindications for TT and surgery underwent UFH therapy. RESULTS: A total of 
      136 patients were enrolled [male: 55 (40.4%), mean age: 50.3 +/- 14.6 years] in the 
      study. In the successful group, 66 patients (48,5%) showed >75% regression in the 
      thrombus burden without facing death or major non-fatal complications.In the 
      unsuccessful group, 56 had less than a 50% reduction in thrombus load and 14 
      (10.3%) suffered major complications. The presence of obstruction (27.1% vs. 
      12.1%; p = 0.028), thrombus area 1.1 cm(2) vs. 0.8 cm(2); p = 0.005] and the 
      duration of UFH treatment (15.1 vs. 11.8 (days); p = 0.005) were significantly 
      higher in the unsuccessful UFH group.In multivariate regression analyses the 
      presence of obstruction (RR: 3.088, p = 0.020), increased thrombus area (RR: 
      2.400; p = 0.015), and increased duration of UFH therapy (RR: 1.073 95%, 
      p = 0.012) were identified as independent predictive parameters for a failed UFH 
      therapy. CONCLUSIONS: This study suggests that UFH therapy may be considered a 
      relatively beneficial treatment strategy for some patients with PVT. The most 
      significant factors affecting success are the obstructive nature and area of the 
      thrombus.
CI  - Copyright (c) 2024 Elsevier B.V. All rights reserved.
FAU - Kalkan, Semih
AU  - Kalkan S
AD  - Department of Cardiology, Basaksehir Cam Sakura City Hospital, Istanbul, Turkiye. 
      Electronic address: semihby1@gmail.com.
FAU - Gursoy, Mustafa Ozan
AU  - Gursoy MO
AD  - Department of Cardiology, Izmir Katip Celebi University, Ataturk Training and 
      Research Hospital, Izmir, Turkey.
FAU - Guner, Ahmet
AU  - Guner A
AD  - Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery 
      Training and Research Hospital, Istanbul, Turkey.
FAU - Kalcik, Macit
AU  - Kalcik M
AD  - Department of Cardiology, Faculty of Medicine, Hitit University, Corum, Turkey.
FAU - Bayam, Emrah
AU  - Bayam E
AD  - Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, 
      Istanbul, Turkey.
FAU - Gunduz, Sabahattin
AU  - Gunduz S
AD  - Department of Cardiology, Faculty of Medicine, Bahcesehir University, Istanbul, 
      Turkey.
FAU - Ozkan, Mehmet
AU  - Ozkan M
AD  - Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, 
      Istanbul, Turkey; Division of Health Sciences, Ardahan University, Ardahan, 
      Turkey.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20240319
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 9005-49-6 (Heparin)
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Humans
MH  - Male
MH  - Adult
MH  - Middle Aged
MH  - Heparin
MH  - Retrospective Studies
MH  - *Heart Valve Prosthesis/adverse effects
MH  - *Heart Valve Diseases/diagnosis
MH  - *Thrombosis/diagnostic imaging/drug therapy/etiology
MH  - Anticoagulants
MH  - Heparin, Low-Molecular-Weight
OTO - NOTNLM
OT  - Prosthetic heart valve
OT  - Surgery
OT  - Thrombolysis
OT  - Thrombosis
OT  - Unfractionated heparin
COIS- Declaration of competing interest All of the authors have no conflict of 
      interest.
EDAT- 2024/03/20 00:42
MHDA- 2024/04/08 06:42
CRDT- 2024/03/19 20:13
PHST- 2024/03/05 00:00 [received]
PHST- 2024/03/12 00:00 [accepted]
PHST- 2024/04/08 06:42 [medline]
PHST- 2024/03/20 00:42 [pubmed]
PHST- 2024/03/19 20:13 [entrez]
AID - S0167-5273(24)00518-7 [pii]
AID - 10.1016/j.ijcard.2024.131968 [doi]
PST - ppublish
SO  - Int J Cardiol. 2024 Jun 1;404:131968. doi: 10.1016/j.ijcard.2024.131968. Epub 
      2024 Mar 19.