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The Characteristics and Outcomes of Native Aortic Valve Thrombosis
Journal of the American College of Cardiology ( IF 24.0 ) Pub Date : 2021-08-16 , DOI: 10.1016/j.jacc.2021.06.023
Wissam Alajaji 1 , John M Hornick 1 , Eliane Malek 2 , Allan L Klein 3
Affiliation  

Background

There is a lack of knowledge in the current medical literature about native aortic valve thrombosis.

Objectives

The aim of this systematic review was to summarize the characteristics, presentations, underlying etiologies, and outcomes of native aortic valve thrombosis and to present a meta-analysis of the best available data.

Methods

The authors performed a literature search, identified published cases of patients with native aortic valve thrombosis, and pooled the data in this meta-analysis. The statistical analysis included calculations of the prevalence of the various presentations, underlying etiologies, aortic cusp involvement, as well as choices of diagnostic testing. They calculated the sensitivities of the various diagnostic testing as well as in-hospital mortality event rates and the univariate ORs of the risk factors for poor outcomes.

Results

The search strategy and screening process yielded 74 cases of native aortic valve thrombosis, which are included in this meta-analysis. The data revealed that the most common presentation was myocardial infarction in 36%, and the most common underlying etiology was hypercoagulable state in 30%. In-hospital clinical deterioration after presentation including recurrent embolism occurred in ∼38%, and in-hospital mortality rate was ∼20%.

Conclusions

Native aortic valve thrombosis is clinically relevant, especially in patients presenting with embolic events. Awareness about native aortic valve or root thrombosis as well as its underlying etiologies, diagnostic work-up, and management is essential, because this condition can be associated with poor outcomes.



中文翻译:

自体主动脉瓣血栓形成的特征和结果

背景

当前医学文献中缺乏关于天然主动脉瓣血栓形成的知识。

目标

本系统评价的目的是总结自体主动脉瓣血栓形成的特征、表现、潜在病因和结果,并对现有的最佳数据进行荟萃分析。

方法

作者进行了文献检索,确定了已发表的自体主动脉瓣血栓形成患者的病例,并在本荟萃分析中汇总了数据。统计分析包括计算各种表现的患病率、潜在病因、主动脉瓣受累以及诊断测试的选择。他们计算了各种诊断测试的敏感性以及住院死亡率事件率和不良结果风险因素的单变量 OR。

结果

搜索策略和筛选过程产生了 74 例自体主动脉瓣血栓形成,包括在本荟萃分析中。数据显示,最常见的表现是 36% 的心肌梗塞,最常见的潜在病因是 30% 的高凝状态。约 38% 的患者出现包括复发性栓塞在内的院内临床恶化,院内死亡率约为 20%。

结论

自体主动脉瓣血栓形成具有临床意义,尤其是在出现栓塞事件的患者中。了解自体主动脉瓣或根部血栓形成及其潜在病因、诊断检查和管理是必不可少的,因为这种情况可能与不良结果有关。

更新日期:2021-08-17
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