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 November 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.