Introduction: Mechanical valve thrombosis (MVT) is a life-threatening complication of prosthetic heart valve implantation and remains a major cause of morbidity and mortality despite advances in prosthetic valve design and anticoagulation therapy. This review aims to summarize the current evidence on the pathophysiology, risk factors, clinical presentation, diagnosis, and contemporary management of MVT .
Methods: A structured narrative review of the literature was conducted using PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar. Relevant clinical practice guidelines, systematic reviews, randomized controlled trials, observational studies, and landmark publications addressing mechanical heart valve thrombosis were critically reviewed and synthesized.
Results: The available evidence indicates that thrombus formation is a multifactorial process involving prosthetic valve characteristics, altered hemodynamics, coagulation activation, and patient-related factors. Inadequate anticoagulation remains the most important modifiable risk factor for MVT. Contemporary multimodality imaging, including transthoracic echocardiography, transesophageal echocardiography, fluoroscopy, and cardiac computed tomography, has substantially improved diagnostic accuracy and facilitates differentiation between thrombus and pannus. Current treatment strategies include optimization of anticoagulation, thrombolytic therapy, or surgical intervention, depending on the patient's clinical condition, thrombus characteristics, and prosthetic valve function .
Conclusion: Mechanical heart valves continue to provide excellent long-term durability; however, valve thrombosis remains a significant clinical challenge. Early diagnosis, individualized anticoagulation management, and appropriate application of multimodality imaging are essential for improving clinical outcomes. Future prospective studies are warranted to optimize preventive strategies and establish evidence-based management algorithms for patients with mechanical valve thrombosis.