Thrombolysis of an acute prosthetic mitral valve thrombosis presented with cardiogenic shock under the guidance of continuous transoesophageal monitoring.
Thrombotic occlusion of prosthetic valves continues to be an uncommon but serious complication. Intravenous thrombolytic treatment has been proposed as an alternative to surgical intervention. Due to the lack of a generally accepted standard regimen, various infusion protocols and thrombolytic doses were used for the management of prosthetic heart valve thrombosis. However, rapid thrombolytic infusion, especially in the presence of large thrombus, may increase the risk of embolization. Continuous transoesophageal echocardiography may provide monitoring the efficacy of thrombolysis especially in critically ill patients.
Biteker
Murat
M
Cardiology Department, Kosuyolu Heart and Research Hospital, Istanbul, Turkey. murbit2@yahoo.com
Duran
Nilüfer Eksi
NE
Gündüz
Sabahattin
S
Gökdeniz
Tayyar
T
Kaya
Hasan
H
Aykan
Ahmet Cagri
AC
Ozkan
Mehmet
M
D016903:Drug Monitoring / Q000379:methods; D017548:Echocardiography, Transesophageal; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator