scholarly journals Fibrinolytic Treatment after Transient Ischaemic Attack Caused by Prosthetic Mitral Valve Thrombosis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Cornel Koban ◽  
Michael Neuß ◽  
Grit Tambor ◽  
Frank Hölschermann ◽  
Christian Butter
Keyword(s):  
Mitral Valve ◽  
Complete Resolution ◽  
Prosthetic Valve ◽  
Prosthetic Valve Thrombosis ◽  
Echocardiographic Examination ◽  
Valve Thrombosis ◽  
Life Threatening ◽  
Ischaemic Attack ◽  
Prosthetic Mitral Valve ◽  
Surgical Valve Replacement

Prosthetic valve thrombosis is one of the most severe complications after surgical valve replacement. There are many possible presentations: from asymptomatic to life-threatening complications. We report on a 61-year-old female patient with prosthetic replacement of the aortic and mitral valve in the in-house department of cardiac surgery 3 months ago. The patient was suffering from aphasia during 5 minutes in domesticity. After her presentation in the emergency room, the echocardiographic examination revealed a thrombotic formation of the prosthetic mitral valve. At presentation, the anticoagulation was outside the effective range (INR: 1.7). A successful thrombolytic therapy with the plasminogen activator urokinase was begun with complete resolution of the thrombus.

scholarly journals Successful Fibrinolytic Therapy in a Challenging Obstructive Prosthetic Mitral Valve Thrombosis

2020 ◽  
Vol 8 ◽  
pp. 232470962092107
Author(s):  
Amr Essa ◽  
Toufik Haddad ◽  
Terrence Slattery
Keyword(s):  
Mitral Valve ◽  
Prosthetic Valve ◽  
Multimodality Imaging ◽  
Fibrinolytic Therapy ◽  
Mitral Valve Surgery ◽  
Prosthetic Valve Thrombosis ◽  
Valve Thrombosis ◽  
Mean Pressure ◽  
Normal Mean ◽  
Prosthetic Mitral Valve

Prosthetic valve thrombosis is a rare and severe complication of the mechanical prosthetic valve. Management can be challenging due to varying clinical presentation, overlapping features of differential diagnosis, and lack of randomized controlled trials on the therapeutic options. In this article, we report the case of a patient with a mechanical prosthetic mitral valve presented with symptoms of heart failure, and an echocardiography showing increased mean pressure gradient across the prosthesis along with a fixed posterior leaflet and a partially restricted anterior leaflet with no visible mass. That raised the concern for an obstructed prosthesis. After multimodality imaging and multidisciplinary team discussions, prosthetic valve thrombosis diagnosis was favored over other different diagnoses that included but not limited to pannus ingrowth. Fibrinolytic therapy was administrated, and the patient was discharged on optimal anticoagulation. Repeated echocardiography a month later showed normal mean gradient and normal functioning prosthetic mitral valve without the need for repeat mitral valve surgery.

Transcatheter mechanical manipulation of obstructed prosthetic mitral valve in an infant

2020 ◽  
Vol 30 (11) ◽  
pp. 1747-1749
Author(s):  
Yousef Arar ◽  
Jeff Hong ◽  
Surendranath Veeram Reddy
Keyword(s):  
Mitral Valve ◽  
Prosthetic Valve ◽  
Transoesophageal Echocardiography ◽  
Pulmonary Haemorrhage ◽  
Treatment Modalities ◽  
Prosthetic Heart Valves ◽  
Systemic Thrombolysis ◽  
Prosthetic Valve Thrombosis ◽  
Valve Thrombosis ◽  
Prosthetic Mitral Valve

AbstractProsthetic valve thrombosis is a serious complication of prosthetic heart valves that typically requires either surgical intervention or systemic thrombolysis. In patients with contraindications to both treatment modalities, options can be limited. We describe an alternative approach to managing prosthetic valve thrombosis in an infant presenting in extremis with pulmonary haemorrhage. Using transoesophageal echocardiography and fluoroscopic guidance, we restored function to the infant’s obstructed St. Jude prosthetic mitral valve through percutaneous transcatheter manipulation of the valve’s leaflets.

scholarly journals Modified fibrinolytic therapy as treatment of mechanical aortic valve thrombosis

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199920
Author(s):  
Ala Mustafa ◽  
Todd Thomas ◽  
Robert Murdock ◽  
Samuel Congello
Keyword(s):  
Aortic Valve ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Treatment Options ◽  
Fibrinolytic Therapy ◽  
Current Management ◽  
Prosthetic Valve Thrombosis ◽  
Mechanical Aortic Valve ◽  
Valve Thrombosis ◽  
Surgical Valve Replacement

Prosthetic valve thrombosis is a rare phenomenon with limited treatment options. Current management choices include anticoagulation with or without fibrinolysis or surgical valve replacement for appropriate candidates. We report an alternative fibrinolytic and anticoagulation regimen resulting in successful treatment of a patient presenting with mechanical aortic valve thrombosis.

scholarly journals Successful Low-Dose tPA for Mechanical Mitral Valve Thrombosis in a Patient with Postinfarction Contained Left Ventricular Free Wall Rupture

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
James Livesay ◽  
Emmanuel Isang ◽  
Hassan Tahir ◽  
Raj Baljepally
Keyword(s):  
Mitral Valve ◽  
Prosthetic Valve ◽  
Low Dose ◽  
Bleeding Risk ◽  
Left Ventricular ◽  
Free Wall ◽  
Left Ventricular Free Wall ◽  
Prosthetic Valve Thrombosis ◽  
Free Wall Rupture ◽  
Valve Thrombosis

Prosthetic valve thrombosis is a potentially life-threatening complication diagnosed by a combination of clinical features and imaging modalities, but the optimal management in high bleeding risk patients remains controversial. Current treatment options for prosthetic valve thrombosis included surgery, thrombolytic therapy, and anticoagulation. We present a very unusual case of a patient with a recent ST-elevation myocardial infarction complicated by contained left ventricle free wall rupture and mechanical mitral valve thrombosis. Deemed a high surgical risk candidate, low-dose tissue plasminogen activator was used despite significant bleeding risk from contained left ventricle free wall rupture, which resulted in resolution of the thrombus. To the best of our knowledge, this is the first report of successful thrombolytic therapy for prosthetic mechanical mitral valve thrombosis in a patient with recent postmyocardial infarction contained left ventricular free wall rupture.

scholarly journals Severe Vascular Complications Following Thrombolytic Therapy in a Case of Prosthetic Mitral Valve Thrombosis – A Case Report

2021 ◽  
Vol 10 (14) ◽  
pp. 1035-1038
Author(s):  
Ayan Husain ◽  
Shilpa Abhay Gaidhane ◽  
Priti Abhay Karadbhajane ◽  
Sourya Acharya ◽  
Apoorva Nirmal
Keyword(s):  
Thrombolytic Therapy ◽  
Prosthetic Valve ◽  
Prosthetic Heart Valve ◽  
Vascular Complications ◽  
Mechanical Valve ◽  
Fibrinolytic Therapy ◽  
Prosthetic Valve Thrombosis ◽  
Valve Thrombosis ◽  
Prosthetic Mitral Valve ◽  
Immediate Surgery

Prosthetic cardiac valve thrombosis is a rare but dangerous complication; 1,2 particularly in patients with low conformity on anticoagulant therapy. Thromboembolic problems happen after mechanical valve substitution in 0.5 - 8 percent. 3-5 Fibrinolytic therapy to treat the thrombosis is widely used nowadays with high efficacy and no severe side effects as compared to emergency surgical treatment, which is associated with high mortality.6 Surgical valve repair in patients with rheumatic heart disease remains the gold standard for the treatment. Thrombosis of the prosthetic heart valve in patients undergoing valve replacement, is the most severe and deadly complication. Currently, the treatments available for symptomatic prosthetic valve thrombosis are immediate surgery or thrombolytic therapy (TT). In rural hospital settings patients are poor and there is a lack of surgical expertise. These factors make TT the perfect treatment for prosthetic valve thrombosis. But one should be aware of embolic complications.

RESULT OF SLOW INFUSION OF STREPTOKINASE THERAPY IN LEFT SIDED PROSTHETIC VALVE THROMBOTIC OCCLUSION- A CASE SERIES FROM A TERTIARY CARE HOSPITAL IN EASTERN INDIA

2021 ◽  
pp. 14-16
Author(s):  
Saroj Mandal ◽  
Suvendu Chatterjee ◽  
Kaushik Banerjee ◽  
Sidnath Singh
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Thrombolytic Therapy ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Minor Bleeding ◽  
Care Hospital ◽  
Prosthetic Valve Thrombosis ◽  
Valve Thrombosis ◽  
Slow Infusion

Prosthetic valve thrombosis (PVT) is a life threatening complication seen after heart valve replacement and is associated with high mortality and morbidity. Surgical approach or brinolysis and heparin therapy are considered as treatments of choice according to the clinical status of the patient. Thrombolytic therapy has been tried in cases with acute prosthetic valve thrombosis as an alternative to emergency operation with variable results. But fear of peripheral embolism has limited its use in left-sided valve occlusions. The incidence of complications decreases with low dose and slow infusion of brinolytic therapy. In this study we are presenting our experience of thrombolytic therapy with streptokinase in 40 patients who had presented with acute or subacute left-sided prosthetic valve thrombosis. In this study the mean age was 40.9 years (SD-11.2, range-19 to 64 year) with majority (77.5%) were below 50 year of age. Duration of valve replacement was 2.95 ± 1.74 years (1 to 7 years). Average time of presentation since onset of symptoms was 4.75 ± 2.77 days (1 to 12 days). Majority was presented with NYHA class IV symptoms (22/40) and 50% patients presented with cardiogenic shock. 85% patients had atrial brillation and the anticoagulation status was inadequate in 62.5% cases. Overall aortic valve involvement was 37.5% (15 patients) and mitral valve involvement was 62.5% (25 patients). Average mean gradient for aortic valve was 64.5 ±4.2 mm of Hg and that in case of mitral valve was 23.4±3.7 mm of Hg. Duration of thrombolytic therapy was individualized. Average total dose of streptokinase per patient was 25,25000 ± 8,69350 U (ranging from 20,00000 to 50,00000 U) with majority (28/40) had received a total 20,00000U of streptokinase. Patients were re-evaluated after thrombolysis with clinical, echocardiographic, and cine-uoroscopic evaluation. Total complications (both major and minor bleeding) occurred in 8 patients. Most of them were minor like injection site hematoma, gum bleeding transient GI bleed (hematemesis), hemoptysis and those were resolved spontaneously with conservative management/observational care. Thrombolysis was unsuccessful in 2 patients and death due to massive hemorrhagic CVA occurred in 2 patients. Overall success rate was 90% (36/40). In conclusion, the present study demonstrates the feasibility of thrombolytic therapy for left-sided prosthetic valve occlusion.

A Successful Case of Repeat Thrombolysis in Acute Prosthetic Valve Thrombosis

2010 ◽  
Vol 9 (2) ◽  
pp. 73-75
Author(s):  
Shairana Naleem ◽  
◽  
Muhammad Abdulmajid Patel ◽  
Sandeep Basavarajaiah ◽  
Rajesh Aggarwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Prosthetic Valve ◽  
Heart Valves ◽  
Therapeutic Modalities ◽  
Prosthetic Valve Thrombosis ◽  
Acute Medical Unit ◽  
Successful Case ◽  
Valve Thrombosis ◽  
Prosthetic Mitral Valve

Acute heart failure is an important presentation in the Acute Medical Unit. We describe a case of successful repeat thrombolysis in an elderly woman presenting as an emergency with severe pulmonary oedema, due to acute prosthetic mitral valve thrombosis. The diagnostic imaging and therapeutic modalities available are also described.This case highlights the need for acute physicians to consider prosthetic valve thrombosis in the differential for patients with metallic heart valves who present with acute heart failure or cardiogenic shock.

scholarly journals Surgical treatment of a case of acute left heart failure caused by prosthetic valve thrombosis after mitral valve replacement

2021 ◽  
Author(s):  
pengying zhao ◽  
ruisheng liu ◽  
bing song
Keyword(s):  
Heart Failure ◽  
Surgical Treatment ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Prosthetic Heart Valve ◽  
Left Heart ◽  
Left Heart Failure ◽  
Prosthetic Valve Thrombosis ◽  
Valve Thrombosis

Prosthetic valve thrombosis ( PVT) is a serious complication after prosthetic heart valve replacement.When thrombosis causes the prosthetic valve to disfunction, it may cause the patient to die.We successfully treated a patient with acute left heart failure due to prosthetic valve thrombosis. The report is as follows.

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