Interactive Case Study Companion

Metal valve strut

4 - Heart, thrombosed mechanical valve prosthesis - Gross  
One of the metal struts of this mechanical prosthetic valve is visible above an accumulation of tan-to-dark brown thrombi. These partially organized thrombi extend from the rim of the prosthesis into the orifice of the valve. The occluder (the portion of the mechanical valve that blocks back flow across the valve) of the valve is held in an open position by the organizing thrombus partially filling the valve orifice. Mechanical heart valves are generally more durable and can last longer than bioprosthetic valves. Their primary disadvantage is that the patients must receive continuous anticoagulation therapy to prevent thrombi from forming on the nonbiologic surfaces of these valves. Mechanical valves can also damage red cells and may be associated with a destructive hemolytic anemia.  
What percentage of bioprosthetic valves fail within 10 years?
What other problems might this patient have had as a result of organizing thrombi in the orifice of this prosthetic valve?


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