title: Successful application of thrombolysis and angioplasty in case of mechanical aortic valve and coronary graft thrombosis.
abstract: Prosthetic valve thrombosis (PVT) is a rare and fatal complication requiring immediate treatment. Optimal management of the left-sided obstructive PVT is still controversial and depends on patient's status, estimated risk of surgery, thrombus location and size, and clinician's experience. We report a case of a 71-year-old woman, presenting with signs of cardiogenic shock. Transesophageal echoscopy was used to diagnose acute obstructive thrombosis of the mechanical aortic valve. Concomitant coronary graft thrombosis was suspected due to signs of acute myocardial infarction. Thrombolysis with alteplase and subsequent stenting of the venous graft lead to successful resolution of the thrombotic lesions and a favourable patient outcome. Fibrinolytic therapy followed by angioplasty is a rational treatment alternative for inoperable or high risk patients in the case of concomitant mechanical valve and graft thrombosis.
authors.affiliation: Clinic of Anaesthesiology and Intensive Care, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Ieva
authors.initials: I
authors.lastname: Norkienė
authors.affiliation: Center of Cardiology, Vilnius University Hospital Santariškių Clinics.
authors.forename: Ieva
authors.initials: I
authors.lastname: Kažukauskienė
authors.affiliation: Vilnius University Hospital Santariškių Clinics.
authors.forename: Robertas
authors.initials: R
authors.lastname: Samalavičius
authors.affiliation: Clinic of Cardiovascular Diseases, Faculty of Medicine, Vilnius University.
authors.forename: Kęstutis
authors.initials: K
authors.lastname: Ručinskas
keywords: mechanical valve thrombosis; myocardial infarction; thrombolysis