Recognition and mechanisms of prosthetic valve dysfunction
THE CONTEXT
Prosthetic valve dysfunction may present with unexplained heart failure and can arise through different mechanisms in mechanical and biological valves.
Recognition
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Unexplained symptoms or signs of heart failure in a patient with a prosthetic heart valve require urgent assessment for valve dysfunction.
Mechanical valve failure
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Strut fracture can cause mechanical valve failure with catastrophic regurgitation.
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Mechanical valve thrombosis can cause systemic thromboembolism or valve obstruction, particularly when anticoagulation is inadequate.
Biological valve dysfunction
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Biological valve dysfunction can occur around 8–10 years after implantation. Close surveillance is required when dysfunction becomes evident.