Sandbox:DN
Excessive Anticoagulation and Serious Bleeding With Prosthetic Valves (DO NOT EDIT)
| Class IIa |
| "1. Administration of fresh frozen plasma or prothrombin complex concentrate is reasonable in patients with mechanical valves and uncontrollable bleeding who require reversal of anticoagulation (Level of Evidence: B)" |
Prosthetic Valve Thrombosis
Diagnosis and Follow-up
| Class I |
| "1. TTE is indicated in patients with suspected prosthetic valve thrombosis to assess hemodynamic severity and follow resolution of valve dysfunction.(Level of Evidence: B)" |
| "2. TEE is indicated in patients with suspected prosthetic valve thrombosis to assess thrombus size and valve motion(Level of Evidence: B)" |
| Class IIa |
| "1. Fluoroscopy or CT is reasonable in patients with suspected valve thrombosis to assess valve motion. (Level of Evidence: C)" |
Medical Therapy
| Class IIa |
| "1. Fibrinolytic therapy is reasonable for patients with a throm- bosed left-sided prosthetic heart valve, recent onset (<14 days) of NYHA class I to II symptoms, and a small thrombus (<0.8 cm2) (Level of Evidence: B)" |
| "2. Fibrinolytic therapy is reasonable for thrombosed right-sided prosthetic heart valves (Level of Evidence: B)" |
Intervention
| Class I |
| "1. Emergency surgery is recommended for patients with a throm- bosed left-sided prosthetic heart valve with NYHA class III to IV symptoms(Level of Evidence: B)" |
| Class IIa |
| "1. Emergencysurgeryisreasonableforpatientswithathrombosed left-sided prosthetic heart valve with a mobile or large thrombus (>0.8 cm2) (Level of Evidence: C)" |