title: Successful thrombolysis of a thrombosed prosthetic mitral valve using a synthetic tissue plasminogen activator: a case report.
abstract: BACKGROUND
  Prosthetic valve thrombosis is a rare but life-threatening condition that requires careful evaluation and prompt treatment. While surgical intervention remains the gold standard, thrombolytic therapy is now emerging as a potential substitute. Various thrombolytic treatments including streptokinase, urokinase and recombinant tissue plasminogen activators have been reported with variable success rates. However, the data on the use of tenecteplase (a synthetic tissue plasminogen activator) is limited.
  
  
  METHODS
  A 44-year-old Middle Eastern man with a previously implanted prosthetic mitral valve presented with exertional dyspnea and orthopnea. Investigations revealed a thrombosed prosthetic mitral valve. Successful thrombolysis was achieved using tenecteplase which lead to the complete restoration of valve function with no risk to the patient.
  
  
  CONCLUSIONS
  Prosthetic valve thrombosis is a rare but life threatening condition, the diagnosis of which requires a high index of suspicion. Tenecteplase can be used successfully in the management of such cases. It has proved to be useful with no extra risk to the patient.
authors.affiliation: Department of Cardiac Surgery, Chest Disease Hospital, Al-Jabriah, Kuwait. trinityq8@hotmail.com.
authors.forename: Nael
authors.initials: N
authors.lastname: Al-Sarraf
authors.forename: Fahad
authors.initials: F
authors.lastname: Al-Shammari
authors.forename: Jamal
authors.initials: J
authors.lastname: Al-Fadhli
authors.forename: Emad
authors.initials: E
authors.lastname: Al-Shawaf