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Thrombolytic Therapy with Recombinant Streptokinase for Prosthetic Valve Thrombosis
Author(s) -
López Horacio Pérez,
Lóriga Fidel Manuel Cáceres,
Hernàndez Karel Morlans,
Sánchez Humberto Fagundo,
Jimenez Noel González,
Mirayaga María Acelia Marrero,
Saura Pedro López,
Sigarroa Francis,
Mendoza Yudexi,
Alvarez Julian Rodríguez
Publication year - 2001
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2001.tb01164.x
Subject(s) - medicine , streptokinase , thrombosis , surgery , heart valve , chills , embolism , cardiology , complication , myocardial infarction
A bstract Background : Thrombosis is a serious complication of prosthetic heart valves, and management is often difficult. Thrombolytic therapy is a promising alternative to valve reoperation in the prosthetic valve thrombosis. Methods : Fifteen consecutive patients with prosthetic heart valve thrombosis (10 mitral, 3 aortic, 2 tricuspid) were treated with intravenous recombinant Streptokinase: 250,000 UI given over 30 minutes followed by an infusion an 100,000 UI per hour, always with clinical monitoring and echocardiographic examinations repeated at 24, 48, and 72 hours after starting thrombolytic therapy. Doppler echocardiography was the primary method use for diagnosis and was also used to follow the response to therapy Results : Fibrinolytic treatment was successful in 14 (93.3%) patients. Total response was achieved in 13 (86.6%)patients and partial response in 1 (6.7%) patient; one patient died of ventricular fibrillation. No major hemorrhagic events were observed, peripheral embolism occurred in two cases, and one case of minor peripheral bleeding occurred in another. Some patients experienced fever and chills. Conclusions : The present study demonstrates the feasibility, safety and efficacy of thrombolytic therapy, which may be considered as first‐line therapy for prosthetic heart valve thrombosis.