Comparison of Different TEE-Guided Thrombolytic Regimens for Prosthetic Valve Thrombosis
| Autor: | Evren Kaynak, Sabahattin Gündüz, Murat Biteker, Beytullah Çakal, Cihan Cevik, Ahmet Çağrı Aykan, Mustafa Yildiz, Emre Ertürk, Tayyar Gökdeniz, Ozan Mustafa Gürsoy, Yusuf Karavelioğlu, Nihal Özdemir, Nilüfer Ekşi Duran, Hasan Kaya, Emrah Oğuz, Mehmet Özkan, Süleyman Karakoyun, Mehmet Ali Astarcıoğlu |
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| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Streptokinase Thrombolysis Single Center Surgery Regimen Radiology Nuclear Medicine and imaging medicine Radiology Nuclear Medicine and imaging Prosthetic Valve Thrombosis Bolus (digestion) Complication Prospective cohort study business Cardiology and Cardiovascular Medicine medicine.drug |
| Zdroj: | JACC: Cardiovascular Imaging. 6(2):206-216 |
| ISSN: | 1936-878X |
| DOI: | 10.1016/j.jcmg.2012.10.016 |
| Popis: | Objectives The aim of this prospective study was to identify the most effective and safest regimen among different thrombolytic treatment strategies. Background The best treatment strategies for prosthetic valve thrombosis have been controversial. Methods Transesophageal echocardiography–guided thrombolytic treatment was administered to 182 consecutive patients with prosthetic valve thrombosis in 220 different episodes (156 women; mean age, 43.2 ± 13.06 years) between 1993 and 2009 at a single center. These regimens chronologically included rapid (Group I), slow (Group II) streptokinase, high-dose (100 mg) tissue plasminogen activator (t-PA) (Group III), a half-dose (50 mg) and slow infusion (6 h) of t-PA without bolus (Group IV), and a low dose (25 mg) and slow infusion (6 h) of t-PA without bolus (Group V). The endpoints were thrombolytic success, in-hospital mortality, and nonfatal complication rates. Results The overall success rate in the whole series was 83.2%; it did not differ significantly among Groups I through V (68.8%, 85.4%, 75%, 81.5%, and 85.5%, respectively; p = 0.46). The overall complication rate in the whole series was 18.6%. Although the overall complication rate was similar among Groups I through IV (37.5%, 24.4 %, 33.3%, and 29.6%, respectively; p > 0.05 for each comparison), it was significantly lower in Group V (10.5%, p Conclusions Low-dose slow infusion of t-PA repeated as needed without a bolus provides effective and safe thrombolysis in patients with prosthetic valve thrombosis. (Comparison of Different TRansesophageal Echocardiography Guided thrOmbolytic Regimens for prosthetIc vAlve Thrombosis; NCT01451320 ) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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