Thrombolysis for Prosthetic Valve Malfunction : Case Report and Review

JARUWUN CHAIWORRAMUKKUN, MD* PAKORN CHANDANAMATTHA, MD* SARAN A BOONBAICHAIYA PRUCK, MD*

Affiliation : *Division of Cardiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.

AbstractA 40 year old female with severe mitral valve stenosis, underwent mitral valve replacement by single disc valve 4 years ago. She presented at this admission with a new onset of congestive heart failure. The prothrombin time was inadequate with international normalized ratio (INR) 1.43. Trans thoracic echocardiography revealed high pressure gradient across the mitral valve. Fluoroscopy demon strated restrictive opening of single disc motion. Intravenous thrombolysis was given for presumptive diagnosis of prosthetic valve thrombosis. The patient gradually improved and did not have to undergo surgical correction.

Keywords : Prosthetic Valve Thrombosis, Thrombolytic Therapy, Streptokinase

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