Huge prosthetic mitral valve thrombus: use of serial transesophageal echocardiography guidance in resolution.
The case is presented of a 35-year-old woman with major thrombotic obstruction of a 29-mm St. Jude Medical mitral valve prosthesis. The thrombi were treated with successive intravenous fibrinolysis under transesophageal echocardiographic guidance, without complication. One large and obstructive thrombus with a long and mobile component, and other smaller and mobile thrombi were detected. These were gradually lysed after two successive administrations of streptokinase (1.5 x 10(6) units over 24 h), and one session of recombinant tissue type plasminogen inhibitor (100 mg over 6 h).
Ozdemir
Nihal
N
Kosuyolu Heart & Research Hospital, Department of Cardiology, Kadköy, Istanbul, Turkey.
Kaymaz
Cihangir
C
Ozkan
Mehmet
M
D000328:Adult; D017548:Echocardiography, Transesophageal; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006349:Heart Valve Diseases / Q000188:drug therapy*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D013300:Streptokinase / Q000008:administration & dosage*; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000188:drug therapy
D005343:Fibrinolytic Agents; D013300:Streptokinase