3-6 Predictors of mortality and morbidity
Follow-up after the last episode of valve thrombosis was available in 37 (92.5%) patients. During follow-up, 4 (10.8 %) patients died and 3 (8.1%) patients developed chronic valve dysfunction. Two deaths occurred in patients with post-redo TV replacement (one due to infective endocarditis and another in a patient with associated post-operative stroke and cancer); One death occurred following successful thrombolytic therapy (due to heart failure), and one patient died after unsuccessful anticoagulant intensification with a history of previous thrombolytic therapy and chronic valve dysfunction. The frequency of death and chronic valve dysfunction were 5% and 5% in thrombolytic therapy group, respectively, while these proportions were 25% and 50%, respectively, for anticoagulant intensification group. Moreover, mortality rate in surgical group was 15.3% during follow up.
Atrial fibrillation and RV dysfunction were significantly associated with death by univariate analysis (p = 0.02), though after the multivariate analysis adjusting for age, sex, redo-operation, recurrent episode, and treatment type the correlation was not statistically significant. Survival rate and freedom from chronic valve dysfunction in the first year was 93%, while it was 82% after 4 years. The 10-year survival rate and freedom from chronic valve dysfunction was estimated 75% by Kaplan-Meier curve. The median follow-up duration was 37.2 months (0.99-205.3), depicted in (Fig. 3) .