Partial thrombus resolution with trofiban in a pregnant woman with mechanical prosthetic mitral valve thrombosis.
We present a 15-week pregnant woman who developed mechanical mitral valve thrombosis on a fixed dose of enoxaparin therapy 60 mg twice daily. No reductions were observed in the thrombus size or mean mitral gradient on transesophageal echocardiography (TEE) with 1 week of unfractioned heparin therapy. As the thrombus on TEE imaging was hypermobile and fragile, in addition to a higher dose of enoxaparin (80 mg twice daily), trofiban infusion 0.20 µg/kg per minute was administered for another 1 week. The thrombus on the valve was reduced in size, mobility and fragility of the thrombus diminished, and mean valve gradient decreased on TEE. As complete thrombus resolution was not observed and limitation of valve mobility continued, tissue plasminogen activator (tPA) was given to the patient. A complete thrombus resolution was observed on this therapy. The patient is presented for being the first case in literature whose valvular thrombus reduced with trofiban therapy.
Akcay
Adnan Burak
AB
Department of Cardiology, Mustafa Kemal University Medical Faculty, Hatay, Turkey. burakakcay2002@mynet.com
Yuce
Murat
M
Akcay
Murat
M
Sen
Nihat
N
Soydinc
Hatice Ender
HE
Davutoglu
Vedat
V
D000328:Adult; D017548:Echocardiography, Transesophageal; D017984:Enoxaparin / Q000008:administration & dosage*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology
D017984:Enoxaparin; D005343:Fibrinolytic Agents