title: Thrombolytic therapy with recombinant streptokinase for prosthetic valve thrombosis.
abstract: BACKGROUND
  Thrombosis is a serious complication of prosthetic heart valves, and management is often difficult. Thrombolytic therapy is a promising alternative to valve re-operation in the prosthetic valve thrombosis.
  
  
  METHODS
  Fifteen consecutive patients with prosthetic heart valve thrombosis (10 mitral, 3 aortic, 2 tricuspid) were treated with intravenous recombinant streptokinase: 250,000 UI given over 30 minutes followed by an infusion an 100,000 UI per hour, always with clinical monitoring and echocardiographic examinations repeated at 24, 48, and 72 hours after starting thrombolytic therapy. Doppler echocardiography was the primary method use for diagnosis and was also used to follow the response to therapy
  
  
  RESULTS
  Fibrinolytic treatment was successful in 14 (93.3%) patients. Total response was achieved in 13 (86.6%)patients and partial response in 1 (6.7%) patient; one patient died of ventricular fibrillation. No major hemorrhagic events were observed, peripheral embolism occurred in two cases, and one case of minor peripheral bleeding occurred in another. Some patients experienced fever and chills.
  
  
  CONCLUSIONS
  The present study demonstrates the feasibility, safety and efficacy of thrombolytic therapy, which may be considered as first-line therapy for prosthetic heart valve thrombosis.
authors.affiliation: Center for Biological Research, Clinical Trials Division, Havana, Cuba.
authors.forename: Horacio Pérez
authors.initials: HP
authors.lastname: López
authors.forename: Fidel Manuel
authors.initials: FM
authors.lastname: Cáceres Lóriga
authors.forename: Karel Morlans
authors.initials: KM
authors.lastname: Hernàndez
authors.forename: Humberto Fagundo
authors.initials: HF
authors.lastname: Sánchez
authors.forename: Noel
authors.initials: N
authors.lastname: González Jimenez
authors.forename: Maria Acelia
authors.initials: MA
authors.lastname: Marrero Mirayaga
authors.forename: Pedro
authors.initials: P
authors.lastname: López Saura
authors.forename: Francis
authors.initials: F
authors.lastname: Sigarroa
authors.forename: Yudexi
authors.initials: Y
authors.lastname: Mendoza
authors.forename: Julian
authors.initials: J
authors.lastname: Rodríguez Alvarez
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use; D013300:Streptokinase / Q000627:therapeutic use*; D013927:Thrombosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D013300:Streptokinase