Case Series on prosthetic valve thromboses treated with intravenous thrombolysis at a Tertiary Teaching Hospital in Nairobi – Kenya

Abstract

Valvular heart disease is a significant global health issue, particularly in developing countries where Rheumatic Heart Disease (RHD) is the leading cause. Valve replacement surgeries have increased, with mechanical prostheses favored for their durability. However, thromboembolism remains a critical complication post-surgery, with prosthetic valve thrombosis rates of 0.03% for bioprosthetic valves and between 0.5% to 8% for mechanical valves in the aortic and mitral position. This report details two cases of heart failure following valve replacement due to rheumatic heart disease. The first case involves a 42-year-old female who developed prosthetic valve thrombosis after discontinuing warfarin for menorrhagia postmechanical mitral valve replacement. The second case features a 37-year-old male who experienced valve thrombosis after undergoing mechanical aortic valve replacement and subsequently became dehydrated from acute gastroenteritis while on warfarin. Both patients were managed with anticoagulation and fibrinolysis, highlighting the importance of careful monitoring and management in post-operative care to prevent thromboembolic complications.