Mechanical aortic valve thrombosis with severe valvular dysfunction treated with multiple rounds of thrombolysis

[...]dose of tPA (25 mg over 25 hours) followed by 6-hour UFH infusion was administered with no good results on fluoroscopy. The annual rate of prosthetic mechanical valves ranges from 0.1% to 5.7% with even higher rate in patient not adherent to anticoagulation therapy.1 Diagnosis can be made by ex...

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Bibliographic Details
Published in:BMJ case reports 2020-03, Vol.13 (3), p.e234746
Main Authors: Shabbir, Muhammad Asim, Saad Shaukat, Muhammad Hamza, Joye, Evan, Purga, Scott
Format: Article
Language:English
Subjects:
Adult
Aortic Valve
Blood clots
cardiovascular medicine
Case reports
Ejection fraction
Electrocardiography
Heart
Heart Valve Prosthesis - adverse effects
Heparin - therapeutic use
Humans
Images In
interventional cardiology
Male
pharmacology and therapeutics
Prostheses
Surgery
Thrombolytic Therapy - methods
Thrombosis
Thrombosis - drug therapy
Thrombosis - etiology
Tissue Plasminogen Activator - therapeutic use
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Summary:[...]dose of tPA (25 mg over 25 hours) followed by 6-hour UFH infusion was administered with no good results on fluoroscopy. The annual rate of prosthetic mechanical valves ranges from 0.1% to 5.7% with even higher rate in patient not adherent to anticoagulation therapy.1 Diagnosis can be made by examination, TEE and fluoroscopy; we used the latter modality to assess tPA treatment effect.2 Treatment is either surgery or thrombolysis based on thrombus size and presence of obstruction.3 The major risk of fibrinolytic treatment is bleeding and systemic emboli, including stroke. Learning points Treatment of mechanical valve thrombosis is either surgery or thrombolysis based on thrombus size and presence of obstruction.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-234746