title: Successful thrombolytic treatment of a bio-prosthetic mitral valve thrombosis in a pregnant woman.
abstract: Even though it is a rare complication, the pro-coagulant condition of pregnancy may predispose to thrombosis of a bio-prosthetic mitral valve (BPMV). We report the successful reduced-dose, slow infusion of tissue plasminogen activator (t-PA) to a BPMV thrombosis in a pregnant woman. When the patient was seen in the emergency clinic she was dyspnoeic and tachycardic and evaluated as NYHA class III-IV. On transthoracic echocardiography (TTE) the BPMV leaflet movement was restricted and a high transmitral valve gradient was measured.Transoesophageal echocardiography showed thrombosis of the BPMV. After slow infusion of t-PA with heparin, on TTE the gradient was decreased with free movement of the BPMV leaflet and with fast clinical improvement.
authors.affiliation: Dept. of Cardiology, Kadirli State Hospital, Osmaniye, Turkey. uluganyan@yahoo.com
authors.forename: Mahmut
authors.initials: M
authors.lastname: Uluganyan
authors.forename: Gurkan
authors.initials: G
authors.lastname: Karaca
authors.forename: Zekeriya
authors.initials: Z
authors.lastname: Nurkalem
mesh_terms: D000328:Adult; D001705:Bioprosthesis / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D017548:Echocardiography, Transesophageal; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006349:Heart Valve Diseases / Q000150:complications*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000188:drug therapy; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator