Valve thrombosis and thrombolytic therapy in modern era: a case report

• Autores: Aguilar-Molina, Oswaldo E., Prada-Escobar, David, Gandara-Ricardo, Jairo A., Arroyave- Paramo, Hector D., Senior-Sanchez, Juan M., Munoz-Ortiz, Edison, Gándara-Ricardo, Jairo A., Arroyave- Páramo, Héctor D., Senior-Sánchez, Juan M., Muñoz-Ortiz, Edison
• Formato: artículo
• Fecha de Publicación: 2021
• Institución: Instituto Nacional Cardiovascular
• Repositorio: Archivos peruanos de cardiología y cirugía cardiovascular
• Lenguaje: español; inglés
• OAI Identifier: oai:apcyccv.org.pe:article/149
• Enlace del recurso: https://apcyccv.org.pe/index.php/apccc/article/view/149
• Nivel de acceso: acceso abierto
• Materia: Trombosis; Enfermedades de las válvulas cardíacas; Terapia trombolítica; Insuficiencia cardiaca; Terapéutica; Thrombosis; Heart valve diseases; Thrombolytic therapy; Heart failure; Therapeutics

Prosthetic valve thrombosis is a feared complication with an annual incidence ranging between 0.3 to 1.3%. Diagnostic approach is essential for a better prognosis and ultimately determines the chosen therapeutic strategy. Emergent valvular surgery is usually recommended in hemodinamically unstable patients, large thrombus or recurrent embolic episodes. These high-risk conditions are often not the case. Therefore, in many patients the surgical risk is much greater than that of bleeding associated with thrombolytic administration. Ultra-slow infusions have been reported with similar efficacy and lower rates of bleeding complications. We present a case of mitral prosthetic valve thrombosis considered not feasible to surgical management and subsequently treated with an ultra-slow tissue plasminogen activator infusion.