Table 1.

The etiopathogenesis of prosthetic heart valve thrombosis

I. Molecular interaction between corpuscular blood components and prosthetic surfaces	Initial adsorption of plasma proteins on the prosthesis and adhesion of the platelets (via fibrinogen, fibronectin, von Willebrand factor, vitronectin, thrombospondin, etc.)
II. The effect of the transprosthetic blood flow on local thrombus formation	Adenosine diphosphatase, platelet factor 4, beta-thromboglobulin and other proteins are released, which is associated with the increase in blood-borne shear stress
III. Ineffective anticoagulation	Subtherapeutic international normalized ratio levels
IV. Other prothrombotic factors	Incomplete endothelialization of the sewing ring (the early postoperative period)
	Atrial fibrillation
	Left atrial enlargement
	Multiple valve replacement
	Ventricular dysfunction
	Presence of pannus formation
	Sporadic use of drugs (e.g., contraceptives)
	Malignancy
	Systemic diseases (i.e., systemic lupus erythematosus)
	Pregnancy
	Potential inherited causes (i.e., methylenetetra- hydrofolate reductase A 1298 C, fibrinogen 455G/A polymorphisms)
	Presence of specific antibodies (anticardiolipin, anti-tissue plasminogen activator antibodies, etc.)
	Heparin-induced thrombocytopenia