title: Thrombolytic therapy with tissue plasminogen activator for the treatment of nonstructural malfunction of bileaflet cardiac valve prostheses.
abstract: This study was conducted to determine the effect of thrombolytic therapy with tissue plasminogen activator (t-PA) for nonstructural malfunction of bileaflet cardiac valve prostheses. Twenty-seven patients with bileaflet prosthetic valve malfunction diagnosed by a combination of cineradiography and transthoracic echocardiography were treated with the administration of intravenous t-PA. The treatment resulted in complete success in 55.6% (15 of 27), partial success in 22.2% (6 of 27), and no change in 22.2% (6 of 27). In the complete success and partial success groups, the condition of the patients in 85.7% (18 of 21) of the cases improved within 24 h after the administration of t-PA. Six cases in whom thrombolytic therapy was instituted more than 1 month (ranged from 1 to 38 months, mean 14.7 months) after the diagnosis of prosthetic valve malfunction showed significantly less effectiveness of thrombolytic therapy with t-PA. Only one patient (3.7%) had a major complication (thromboembolism) after t-PA treatment. The results suggest that thrombolytic therapy with t-PA in patients with nonstructural malfunction of bileaflet cardiac valve prostheses is effective with low incidence of complication when the treatment is instituted early after the diagnosis.
authors: Department of Surgery, Kurume University School of Medicine, Asashi-machi, Kurume, Japan. tesshi@med.kurume-u.ac.jp
authors: Hideki
authors: H
authors: Teshima
authors: Nobuhiko
authors: N
authors: Hayashida
authors: Masaru
authors: M
authors: Nishimi
authors: Eiki
authors: E
authors: Tayama
authors: Shuji
authors: S
authors: Fukunaga
authors: Hiroshi
authors: H
authors: Tomoeda
authors: Shingo
authors: S
authors: Chihara
authors: Naofumi
authors: N
authors: Enomoto
authors: Takemi
authors: T
authors: Kawara
authors: Shigeaki
authors: S
authors: Aoyagi
mesh_terms: D000328:Adult; D000368:Aged; D002933:Cineradiography; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000627:therapeutic use*; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator