Table 1.
Recommendations in left-sided obstructive prosthetic valve thrombosis.
| Guideline | Publication year | Main determinant | Treatmenta |
|---|---|---|---|
| ESC4 | 2007 | All patients | Surgery (I, C) (Fibrinolysis if surgery is contraindicated) |
| ACC/AHA22 | 2008 | NYHA III–IV | Surgery (IIa, C) (fibrinolysis if surgery is contraindicated or unavailable) |
| NYHA I–II, large thrombus burden | Surgery (IIa, C) | ||
| NYHA I-II, small thrombus burden | Thrombolysis (IIb, B) | ||
| SHVD23 | 2005 | Thrombus size >5 mm | Thrombolysis (regardless of NYHA class, unless contraindicated, presence of left atrial thrombus is contraindication) |
| ACCP24 | 2008 | Thrombus burden <0.8 cm2 | Thrombolysis (II, C) (regardless of NYHA class) |
| Thrombus burden >0.8 cm2 | Surgery (II, C) (thrombolysis if surgery is high risk or unavailable) |
a
Class and level of evidence are given. ACC/AHA, American College of Cadiology/American Heart Association; ACCP, American College of Chest Physicians; ESC, European Society of Cardiology; NYHA, New York Heart Association; SHVD, Society of Heart Valve Disease.