PREVENTION AND MANAGEMENT OF DYSFUNCTION OF PROSTHETIC HEART-VALVES

The ideal heart valve prosthesis has not been developed. The today ava ilable mechanical and biological prostheses are far from perfect conce rning thrombogenesis, mechanical durability and hemodynamic performanc e. Failure of an implanted valve is possible due to inadequate indicat ion, inadequate surgical technique and inadequate medical follow-up. T he patient with a heart valve prosthesis must be seen as a livelong ch allenge for the cooperation between cardiologists and cardiac surgeons . This article describes the main causes of prosthetic heart valve dys function and the surgical treatment, including structural dysfunction, thrombosis, paravalvular leakage, tissue ingrowth and prosthetic valv e endocarditis.