A Study on Prosthetic Valve Dysfunction and Its Complications in a Tertiary Care Teaching Hospital

Introduction: Prosthetic valve dysfunction remains a significant cause of morbidity and mortality following valve replacement surgery. Despite advances in valve technology and surgical techniques, complications including thrombosis, structural deterioration, pannus formation, and endocarditis continue to affect patient outcomes. This study aimed to evaluate the clinical spectrum, etiological factors, complications, and outcomes of prosthetic valve dysfunction in a tertiary care setting in South India. Methods: A prospective observational study was conducted at Government Tiruvannamalai Medical College Hospital for a period of two years. Fifty patients presenting with prosthetic valve dysfunction were enrolled. Detailed clinical history, physical examination, laboratory investigations, and comprehensive echocardiographic evaluation were performed. Patients were classified based on valve type, position, etiology of dysfunction, and complications. Management strategies included conservative medical therapy, thrombolysis, and surgical intervention. Outcomes including mortality, morbidity, and functional status were analyzed. Results: Among 50 patients studied, 45(90%) had mechanical valves and 5(10%) had bioprosthetic valves. Mean age was 45.6 years with male predominance (62%). Structural valve deterioration was the most common cause in bioprosthetic valves (61.1%), while thrombosis predominated in mechanical valves (43.8%). Pannus formation occurred in 25% of mechanical valves. The mitral position was most frequently affected (56%). Major complications included heart failure (56%), thromboembolism (30%), and endocarditis (14%). Surgical intervention was required in 10% of patients. Overall mortality was 16%, with cardiogenic shock and sepsis as leading causes of death. Conclusion: Prosthetic valve dysfunction presents with diverse etiologies and significant complications in our population. Suboptimal anticoagulation control was strongly associated with thrombotic complications. Regular surveillance, patient education, optimal anticoagulation management, and timely intervention are essential to improve outcomes. Structured follow-up programs and accessible monitoring facilities are critical for preventing catastrophic complications in resource-limited settings.