Figure 7. Evaluation and Management of Suspected
Prosthetic Valve Thrombosis
Suspected Prosthetic
Valve rombosis
Le-sided
prosthetic valve
thrombosis
CT or fluoroscopy
to evaluate valve
motion
(IIa)
TTE to evaluate
hemodynamic severity
(I)
Prosthetic Valves
Right-sided
prosthetic valve
thrombosis
TEE for thrombus size
(I)
NYHA
class III-IV
symptoms
Recent onset (<14 d)
NYHA class I-II symptoms
Small thrombus (<0.8 cm
2
)
Mobile or large
(≥0.8 cm
2
)
thrombus
Fibrinolytic Rx if persistent
valve thrombosis aer IV
heparin Rx
(IIa)
Emergency
surgery
(IIa)
Emergency
surgery
(I)
40
