Combined thrombolytic therapy for prosthetic mitral valve thrombosis.
Prosthetic valve thrombosis is associated with high mortality. The treatment of choice remains operation. This is a case report of the successful combination therapy of tissue plasminogen activator and urokinase for an isolated thrombosed prosthetic mitral valve in a postpartum patient in whom operation was thought to carry an unacceptable risk. Combined thrombolytic therapy or therapy with a single agent with a long half-life and a prolonged infusion time is suggested as an emergent treatment option for prosthetic mitral valve thrombosis.
Jost
C M
CM
Department of Internal Medicine, UT Southwestern Medical Center, Dallas 75235-9034.
Yancy
C W
CW
Ring
W S
WS
D000293:Adolescent; D004359:Drug Therapy, Combination; D005260:Female; D006350:Heart Valve Prosthesis; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011644:Puerperal Disorders / Q000188:drug therapy*; D012214:Rheumatic Heart Disease / Q000601:surgery*; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use*; D014568:Urokinase-Type Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use*
D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator