European Journal of Molecular & Clinical Medicine

Abstract

Background: Prosthetic heart valve thrombosis (PHVT) is a very rare complication after the replacement of a damaged valve by a mechanical valve. It contributes significantly to the late morbidity and mortality after heart valve surgery. The incidence varies across the world depending on the type of mechanical heart valve and its position. A little study was done on the absolute eosinophil count in prosthetic heart valve thrombosis. So in the present study, we are evaluating the risk factors, clinical profile and levels of absolute eosinophil count in prosthetic heart valve thrombosis cases.
Methodology: A prospective observational study was carried out at Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru from March 2015-December 2017. A total of 73 patients with PHVT were studied during this period. Data was collected by detailed clinical and treatment profiles and analyzed using SPSS V 23 software and results were represented in tables, figures, percentages, and graphs under descriptive statistics.
Results: Mean age of study participants was 39.7+11.8 years. The percentage of females was higher than males. The main predisposing factor for valve replacement was found to be Rheumatic heart disease (94.5%) and degenerative aortic valve disease was found only in 5.5% of the cases. Mitral valve position (60.3%) was most commonly involved in PVT. After replacement of the valve, 32.9% of patients presented the PHVT after 5 years and 9.6% within 6 months of surgery. Out of 73 patients, 50.7% of cases presented with NYHA class II symptoms, and 69.9% had INR in the non-therapeutic range. Atrial fibrillation was observed in 23.3% of cases atrial tachycardia in 5.5% of cases. Recurrent PVT was observed in 20.5% of cases. The absolute eosinophil count (AEC) was measured in our study 39.7% of cases had elevated levels of AEC.
Conclusion: Prosthetic valve thrombosis is a major cause of morbidity and mortality in cases with heart valve replacement. There is a strong correlation between incidence of PHVT and elevated AEC. Eosinophilia increases the incidence of recurrent PHVT and interferes with events of thrombolysis. Hence it is necessary to check AEC for all cases of PVT for better assessment and management.