Thrombolytic therapy for prosthetic cardiac valve thrombosis.
To determine the efficacy and safety of thrombolytic therapy for prosthetic valve thrombosis, a composite series of 41 patients who received either streptokinase or urokinase intravenously for this disorder were analyzed. The series comprised 3 patients treated at Rhode Island Hospital and 38 previously reported on. Short-term success was achieved in 32 patients (78%). Prosthetic valve thrombosis recurred in seven (22%) of the successfully treated patients, four of whom were retreated with thrombolytic therapy. A favorable clinical outcome was observed in each. Fever and venipuncture bleeding were the most frequent side effects. Systemic embolization occurred in 4 (15%) of 26 patients with either aortic or mitral prosthetic valve thrombosis. None of these latter patients experienced a permanent neurologic or circulatory deficit. It is concluded that thrombolytic therapy is of value in the treatment of prosthetic valve thrombosis.
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D004632:Emergency Medical Services; D005260:Female; D005334:Fever / Q000139:chemically induced; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006350:Heart Valve Prosthesis / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D012086:Reoperation; D013300:Streptokinase / Q000009:adverse effects / Q000627:therapeutic use*; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery
D005343:Fibrinolytic Agents; D013300:Streptokinase