Valvular & structural heart diseaseRandomised controlled trial
Urgent surgery vs fibrinolytic therapy for left-sided prosthetic valve thrombosis: a randomized trial
- Randomised controlled trial
- single-centre
- blinded outcome assessment
Of 32 patients who had surgery, 17 (53%) operated within 48 h
Authors' conclusion
In symptomatic left-sided PVT, urgent surgery is not more efficacious than FT. Surgery is associated with a higher risk of complications, including death, while FT is more often associated with residual valve dysfunction.
Study context
- Population
- Patients with symptomatic left-sided mechanical prosthetic valve thrombosis (PVT)
- Participants
- 79 patients
- Comparison
- Urgent surgery vs fibrinolytic therapy (FT) for symptomatic left-sided PVT
- Urgent surgeryn = 39
- FTn = 40reference
- Primary endpoint
- Complete clinical response: discharge with completely restored valve function, without major complications
- Follow-up
- Discharge
Primary result
As reported in the abstract
Odds ratio
1.22
95% CI 0.46–3.19
P = 0.689
Urgent surgery vs FT
OR 1.22 (95% CI 0.46–3.19); P = 0.689
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Composite of death, non-fatal stroke, non-fatal major bleed or systemic embolism · discharge | 5.14 (1.28–20.5) | P = 0.021 | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | Urgent surgery | FT | Estimate | P value |
|---|---|---|---|---|
| Death | 7/39 | 1/40 |
- Residual valve dysfunction (FT)
- Twenty-five percent · 10 of 40
- Death: P = .035
Original publication
Urgent surgery vs fibrinolytic therapy for left-sided prosthetic valve thrombosis: a randomized trial. Eur Heart J. Published 27 June 2025. doi:10.1093/eurheartj/ehaf391
Summarised from the published abstract; every number is checked against it