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) .