[Fibrinolytic treatment of 28 thromboses of valve prostheses. A biological study].
We carried out a series of laboratory investigation in 28 patients with prosthetic valve thrombosis (17 mitral and 11 aortic). The diagnosis was confirmed by TM and bidimensional echocardiograms and by cineradiography. The treatment consisted of UK (4,500 IU/kg/hour for 12 hours) and/or SK (initial loading dose of 500,000 IU, then 150,000 IU/hour for 10 hours). We measured fibrinogen, degradation products of fibrinogen-fibrin, plasminogen and antiplasmin. Two dimensional electrophoresis against anti-fibrinogen, anti-fragment-D and anti-fragment-E were employed for some samples. After thrombolytic therapy (SK: 18; UK: 7; SK-UK: 2; UK-SK: 1) complete clot removal was obtained in 21 cases (successful: group S), partial removal in 4 cases (improvement: group A) and failure in 3 cases (failure: group E). 3 patients died. Biochemical effects can be seen in group S and in group A. There were no changes in group E.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D004341:Drug Evaluation; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D013300:Streptokinase / Q000008:administration & dosage; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D005343:Fibrinolytic Agents; D006493:Heparin; D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator
Traitement fibrinolytique de 28 thromboses de prothèses valvulaires. Etude biologique.