There is limited clinical experience with left ventricular assist device therapy in patients with prosthetic mitral valves. We present a case of successful left ventricular assist device support in a patient with previous mechanical mitral valve replacement.

The surgical replacement of diseased heart valves is based on the premise that the prosthesis chosen to replace a stenotic or insufficient valve will have a beneficial impact on the patient’s heart function, taking into account the risks of surgery and the recognized complications of prosthetic heart valves. It is well established that mitral valve replacement (MVR) is associated with higher sh...

4 CLINICAL PARTICULARS 4.1 Therapeutic indications As an adjunct to oral anti-coagulation for prophylaxis of thromboembolism associated with prosthetic heart valves. In combination with aspirin for: a. Prophylaxis of deep venous thrombosis as an alternative to subcutaneous heparin, other than in hip surgery. b. Prophylaxis of recurrent venous thrombosis resistant to oral anticoagulation. c. Pro...

1. Permanent therapy with oral anticoagulants offers the most consistent protection in patients with mechanical heart valves. 2. Antiplatelet agents alone do not consistently protect patients with mechanical prosthetic heart valves, including patients in sinus rhythm with St. Jude Medical valves in the aortic position. 3. Levels of oral anticoagulants that prolong the INR to 2.0 to 3.0 appear s...

Two cases of prosthetic valve dysfunction resulting in acute massive mitral regurgitation are reported; emergency operation was successful in both cases. Survival following complete dislodgement of the occluder of a disc valve, as occurred in one case, does not appear to have been reported before. The diffculty in diagnosis of sudden cardiac decompensation in patients with prosthetic valves is ...

Studies correlating prosthetic valve gradients determined by continuous wave Doppler echocardiography with gradients obtained by cardiac catheterization have, to date, been limited to patients with mitral and tricuspid prostheses or have compared nonsimultaneous measurements. Simultaneous Doppler and catheter pressure gradients in 36 patients (mean age, 63+13 years) with 42 prosthetic valves (2...

Prosthetic valve thrombosis (PVT) is a life-threatening complication in pregnant women with mechanical prosthetic heart valves. Thrombolytic therapy (TT) has evolved as an effective treatment alternative to surgery, which is associated with very high maternal and fetal mortality and morbidity in these patients. Acute ischemic stroke may rarely occur during TT for PVT. Here, we present a pregnan...

Prosthetic cardiac valve replacement has been carried out at Brugmann University Hospital since 1962. In a series of 370 valvular replacements, operative and hospital deaths have attained a low rate (5%). The overall survival of 70% is comparable to that of most published series. Late thromboembolic complications, in spite of longterm anticoagulant therapy, remain the principal disadvantage of ...

Heart valve replacement is a common cardiac surgical procedure used to treat native valvular diseases such as aortic and mitral stenosis and regurgitation. These procedures reduce the morbidity and mortality associated with diseased native valves and yet come at the expense of prosthetic valve complications. Structural valve degeneration is one such complication. We present a case of a critical...

Patients with prosthetic heart valves require lifelong oral anticoagulant therapy based on vitamin K antagonists. These patients may need interruption of their anticoagulant therapy if they have to undergo surgery. The clinical challenge is to identify patients who can safely undergo surgery while continuing their vitamin K antagonist treatment and those who have to take short-acting heparin as...