Thrombolytic therapy for mitral valve thrombosis

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

Research output: Contribution to journalArticle

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

Fingerprint

Thrombolytic Therapy
Heart Valves
Mitral Valve
Thrombosis
Transient Ischemic Attack
Tissue Plasminogen Activator
Pulmonary Edema
Warfarin
Nervous System
Echocardiography
Therapeutics
Safety

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Lin, Tin Kwang ; Tsai, Liang-Miin ; Chen, Jyh Hong ; Yang, Yu Jen. / Thrombolytic therapy for mitral valve thrombosis. In: Journal of the Formosan Medical Association. 1997 ; Vol. 96, No. 5. pp. 382-385.
@article{4b54320e45734af2bd9776b42ddde096,
title = "Thrombolytic therapy for mitral valve thrombosis",
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.",
author = "Lin, {Tin Kwang} and Liang-Miin Tsai and Chen, {Jyh Hong} and Yang, {Yu Jen}",
year = "1997",
month = "5",
day = "1",
language = "English",
volume = "96",
pages = "382--385",
journal = "Journal of the Formosan Medical Association",
issn = "0929-6646",
publisher = "Excerpta Medica Asia Ltd.",
number = "5",

}

Lin, TK, Tsai, L-M, Chen, JH & Yang, YJ 1997, 'Thrombolytic therapy for mitral valve thrombosis', Journal of the Formosan Medical Association, vol. 96, no. 5, pp. 382-385.

Thrombolytic therapy for mitral valve thrombosis. / Lin, Tin Kwang; Tsai, Liang-Miin; Chen, Jyh Hong; Yang, Yu Jen.

In: Journal of the Formosan Medical Association, Vol. 96, No. 5, 01.05.1997, p. 382-385.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Thrombolytic therapy for mitral valve thrombosis

AU - Lin, Tin Kwang

AU - Tsai, Liang-Miin

AU - Chen, Jyh Hong

AU - Yang, Yu Jen

PY - 1997/5/1

Y1 - 1997/5/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0030900306&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030900306&partnerID=8YFLogxK

M3 - Article

VL - 96

SP - 382

EP - 385

JO - Journal of the Formosan Medical Association

JF - Journal of the Formosan Medical Association

SN - 0929-6646

IS - 5

ER -