Prosthetic valve thrombosis—should thrombolysis be considered as first line of management?

Autor: Emmanuel Rupert, Pradeep Narayan, Debasis Das, Mrinalendu Das, Saibal Roy Chowdhury, Anton Prem, Niranjan Kumar, Sukanta Kumar Behera
Rok vydání: 2015
Předmět:
Zdroj: Indian Journal of Thoracic and Cardiovascular Surgery. 32:1-4
ISSN: 0973-7723
0970-9134
DOI: 10.1007/s12055-015-0407-0
Popis: Traditionally prosthetic valve thrombosis has been managed with emergency surgery. However, there is growing evidence that thrombolysis is a suitable alternative. In this study, we aim to examine the safety and efficacy of thrombolysis in the management of prosthetic valve thrombosis (PVT). This retrospective study was carried out at a single center between June 2010 and June 2014. All patients presenting with PVT were included in the study. All patients were treated with thrombolysis using our institutional protocol. Nineteen patients presented with 24 episodes of PVT. Overall, 73.6 % (14/19) of the patients were successfully treated with thrombolysis leading to clinical as well as haemodynamic improvement. Four (21 %) patients were taken directly for an operative intervention. The remaining 15 patients had a trial of thrombolysis which was successful in all cases. However, four of these patients had a recurrence within 2 weeks and were offered a second trial of thrombolysis. Three of these patients had a satisfactory outcome, and one patient was taken for surgery. Overall, 73.6 % (14/19) of the patients were successfully treated with thrombolysis. There was one incidence of intracerebral bleed leading to death. Mitral valve was the commonest valve involved in our study. Thrombolysis is safe and may be considered as primary treatment strategy for first episode of prosthetic valve thrombosis. In recurrent thrombosis as well, a trial of thrombolysis can be given.
Databáze: OpenAIRE
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