title: Use of tenecteplase for left-sided prosthetic valve thrombosis.
abstract: BACKGROUND
  Prosthetic valve thrombosis (PVT) following cardiac valve replacement in rheumatic heart disease patients is a common cause for referral to tertiary care centre. Although surgery has been described as the traditional choice of therapy, thrombolytic therapy has reported high success rates in published literature.
  
  
  METHODS
  This is a case report of ten patients with left-sided PVT receiving tenecteplase. The mean dose of tenecteplase used was 1.01 mg/kg given as IV bolus injection along with enoxaparin, heparin and acenocoumarol. The diagnosis and response was assessed based on trans-thoracic echocardiography. The reduction in peak transvalvular gradient was in the range of 46% - 81% and in mean transvalvular gradient was in the range of 50% - 84%. There was normalization of valve motion in all patients. There was no incidence of mortality, intracerebral hemorrhage, systemic bleeding or embolism.
  
  
  CONCLUSIONS
  To our knowledge, this is the largest published evidence so far showing efficacy and safety of tenecteplase for PVT.
authors.affiliation: National Heart Institute, New Delhi.
authors.forename: Vinod
authors.initials: V
authors.lastname: Sharma
authors.forename: Ruchi
authors.initials: R
authors.lastname: Singh
authors.forename: Rekha
authors.initials: R
authors.lastname: Mishra
authors.forename: A P
authors.initials: AP
authors.lastname: Arora
authors.forename: L C
authors.initials: LC
authors.lastname: Gupta
authors.forename: O P
authors.initials: OP
authors.lastname: Yadava
mesh_terms: D000328:Adult; D001021:Aortic Valve; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D000077785:Tenecteplase; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase