Doppler echocardiographic evaluation of streptokinase lysis of thrombosed right-sided St. Jude Medical valves in patients with congenital heart defects.
Four episodes of St. Jude Medical prosthesis leaflet thrombosis were serially evaluated by two-dimensional and Doppler echocardiography during treatment with streptokinase. Three patients aged 4, 11, and 24 years with congenital heart disease had St. Jude Medical valves in pulmonary positions (two cases) for tetralogy of Fallot and in the tricuspid position (one case). The duration of thrombosis was not known in any patient. Leaflet immobility and its resolution were demonstrated by echocardiography and were confirmed fluoroscopically. Continuous wave Doppler echocardiography showed abnormal stenotic gradients in thrombosed valves that were reduced after thrombolysis. These studies demonstrate the utility of two-dimensional and Doppler echocardiography in serial evaluation of prosthetic pulmonary and tricuspid valve thrombosis during thrombolysis.
Fyfe
D A
DA
Division of Pediatric Cardiology, South Carolina Children's Heart Center, Medical University of South Carolina, Charleston 29425.
Taylor
A B
AB
Kline
C H
CH
Sade
R M
RM
Gillette
P C
PC
D000328:Adult; D002648:Child; D002675:Child, Preschool; D004341:Drug Evaluation; D004452:Echocardiography; D015150:Echocardiography, Doppler; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006350:Heart Valve Prosthesis; D006801:Humans; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011664:Pulmonary Valve / Q000000981:diagnostic imaging; D013300:Streptokinase / Q000627:therapeutic use*; D013771:Tetralogy of Fallot / Q000150:complications* / Q000000981:diagnostic imaging; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013997:Time Factors; D014261:Tricuspid Valve / Q000000981:diagnostic imaging
D013300:Streptokinase