Thrombolytic therapy for mitral valve thrombosis

Tin Kwang Lin, Liang Miin Tsai, Jyh Hong Chen, Yu Jen Yang

Research output: Contribution to journalArticlepeer-review

Abstract

A 44 year-old man with a St. Jude mitral valve was admitted because of progressive pulmonary edema. He was diagnosed with prosthetic heart valve thrombosis (PHVT) based on the findings of 'muffled' prosthetic valve clicks, Doppler echocardiographic evidence of severe mitral valve motility. Because the patient hesitated to undergo our recommended surgical treatment, he was immediately treated with intravenous recombinant tissue plasminogen activator (100 mg over 3 h) followed by heparinization. Two hours after the thrombolytic therapy, the prosthetic valve clicks became clearly audible and his congestive symptoms were dramatically improved. Follow-up echocardiography no longer showed significant mitral valve obstruction. A transient cerebral ischemic attack occurred at the end of thrombolytic therapy but there were no neurologic sequalae. The patient, on warfarin therapy, was well at follow-up 18 months after discharge. Surgical intervention has long been the standard therapy for patients with PHVT. Our case experience suggests that thrombolytic therapy may be considered as an effective alternative to surgical intervention for selected patients with PHVT. In this report, we also review the current literature regarding the indications, effectiveness and safety of thrombolytic therapy in PHVT.

Original languageEnglish
Pages (from-to)382-385
Number of pages4
JournalJournal of the Formosan Medical Association
Volume96
Issue number5
Publication statusPublished - 1997 May 1

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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