ABSTRACT
More specifically, we shall deal here with the predictors and management of patients who present embolic complications after prosthetic valve replacement.
Definitions and mechanisms Embolism, as defined by the American Association for Thoracic Surgery and the Society of Thoracic Surgeons, comprises all embolic events that occur after the postoperative period, in the absence of ongoing infection.1 Most cases of embolic events after prosthetic valve replacement are prosthesis-related. However, embolism may also be due to other cardiac causes, such as those originating from the left atrium, in particular the left atrial appendage, or the left ventricle, as well as extracardiac causes.2 Most embolic complications are cerebral in location and it is important to remember that in the general population ischaemic strokes are of non-cardiac origin in around 75-80% of cases. After prosthetic valve replacement, this proportion naturally decreases; however, this does not mean that all the other potential mechanisms of ischaemic stroke, such as atheroma of the aorta, the supra-aortic vessels and even the small intracranial vessels, do not still also play a role.3
