prosthetic heart valve

Introduction

Includes:

• bioprosthetic heart valve
• mechanical heart valve

Diagnostic procedures

• echocardiography at baseline & in patients with signs & symptoms of valve dysfunction
• echocardiography & 5 & 10 years after surgery & annually thereafter for patients with bioprosthetic heart valve
• for patients with transcatheter bioprosthetic heart valve, baseline echocardiogram & annually thereafter
• any change in clinical status suggesting prosthetic valve dysfunction warrants echocardiography
• patients at high risk of endocarditis, thus intermittent fevers need assessment with transthoracic echocardiogram (TTE)
  • if TTE is negative, transesophageal echocardiogram
• routine monitoring with echocardiography otherwise not indicated

Management

• shared decision-making should guide choice of prosthetic valve type.
• anticoagulation with warfarin for at least 3 months for bioprosthetic valve & lifelong for mechanical valve
• aspirin 81 mg QD should be continued indefinitely (both valve types)
• all patients with prosthetic heart valves are at increased risk for infective endocarditis & antibiotic prophylaxis should be given for dental procedures
• interrupt anticoagulation for non-cardiac surgery or dental procedures
  • no interrupt of anticoagulation for cataracts surgery

More general terms

• heart valve
• vascular prosthesis

More specific terms

• bioprosthetic (tissue) heart valve
• mechanical heart valve

Additional terms

• mechanical valve thrombosis; prosthetic valve thrombosis