Successful Thrombolysis of a Thrombosed Mechanical Aortic Valve Prosthesis Using a Slow Intravenous Tenecteplase Infusion

Authors

  • Amir Mohamed Department of Cardiac surgery, Chest Diseases hospital, Kuwait.
  • Aiman Alruwaih
  • Nael Al-Sarraf
  • Medhat Soliman
  • Mohammad Albanna
  • Fahad Al-Shammari

DOI:

https://doi.org/10.3823/1884

Keywords:

thrombolysis, aortic valve, prosthetic valve thrombosis

Abstract

Prosthetic valve thrombosis is defined as any obstruction of prosthesis by non-infective thrombotic material. It has an estimated incidence of 0.03%-4.3% per year and is reported to occur in 0.5%-8% of the left-sided prosthetic valves and in up to 20% of tricuspid prosthesis. We describe a successful treatment of a young man presented with a thrombosed prosthetic aortic valve using a slow intravenous infusion of Tenecteplase without any bolus dose in a newly described dose regimen for aortic valve position and with a complete resolution of the thrombus and regaining the full mobility of both valve leaflets within 48 hours.

References

Caceres-Loriga FM, Perez-Lopez H, Santos-Gracia J, et al. Prosthetic heart valve thrombosis: pathogenesis, diagnosis and management. Int J Cardiol 2006;110:1-6.

Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 129 (23):e521-643.

Lengyel M, Horstkotte D, Vo¨ller H, e al. Working Group Infection, Thrombosis, Embolism and Bleeding of the Society for Heart Valve Disease. Recommendations for the management of prosthetic valve thrombosis. J Heart Valve Dis 2005;14:567-575.

Roudaut R, Lafitte S, Roudaut MF, et al. Management of prosthetic heart valve obstruction: fibrinolysis versus surgery. Early results and long-term follow-up in a single-centre study of 263 cases. Arch Cardiovasc Dis 2009;102:269-277.

Charokopos N, Antonitsis P, Artemiou P, et al. Acute mechanical prosthetic valve thrombosis after initiating oral anticoagulation therapy. Is bridging anticoagulation with heparin required? Interact Cardiovasc Thorac Surg 2009;9:685-687.

Al-Sarraf N, Al-Shammari F, Al-Fadhli J, et al. Successful thrombolysis of a thrombosed prosthetic mitral valve using a synthetic tissue plasminogen activator: a case report. J Med Case Reports 2010, 4:241-244.

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Published

2016-02-14

Issue

Section

Cardiac Surgery & Transplantation