Successful Use of Two Thrombolytic Drugs in Prosthetic Mitral and Aortic Valve Thrombosis

Introduction: Prosthetic valve thrombosis is a rare and severe complication of valve replacement, most often encountered with a mechanical prosthesis. The significant morbidity and mortality associated with this condition warrant rapid diagnostic evaluation. Although surgery is the first-line therap...

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Bibliographic Details
Main Authors: Shayesteh Gheibi, Aliasghar Farsavian, Maryam Nabati, Gohar Eslami
Format: Article
Language:English
Published: Mazandaran University of Medical Sciences 2019-11-01
Series:Pharmaceutical and Biomedical Research
Subjects:
Online Access:http://pbr.mazums.ac.ir/article-1-271-en.html
Description
Summary:Introduction: Prosthetic valve thrombosis is a rare and severe complication of valve replacement, most often encountered with a mechanical prosthesis. The significant morbidity and mortality associated with this condition warrant rapid diagnostic evaluation. Although surgery is the first-line therapy in symptomatic obstructive mechanical valve thrombosis, thrombolytic therapy has been used as an alternative.  Case Description: In this case report, we describe a 46-year-old man with a history of the mitral valve and aortic valve replacement 2 years ago. In echocardiography, we detected a mobile mass on the atrial side of the mitral valve prosthesis and a fixed one on the leaflet of the mechanical aortic valve with a high gradient. To save his life, we used double thrombolytic therapy considering the patient’s hemodynamic situation and the risk of bleeding. Although a routine dose of reteplase and streptokinase was considered, we administered these two thrombolytic drugs together within 72 hours.  Conclucsion: Ultimately we succeeded with this method without any significant or life-threatening adverse effects, and the patient was discharged after an optimal anticoagulation therapy.
ISSN:2423-4494