Successful thrombolysis of late, non-obstructive mitral bioprosthetic valve thrombosis: Case report and review of the literature

Zoltan Pozsonyi, M. Lengyel

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Bioprosthetic valve thrombosis is an unexpected complication which has no guidelines for its management. A 70-year-old female presented 10 days after a stroke, three years after having undergone mitral bioprosthetic valve implantation. Both, transthoracic echocardiography and transesophageal echocardiography (TEE) revealed a large mobile, non-obstructive mass attached to the atrial side of the sewing ring of the bioprosthesis. The administration of low-molecular-weight heparin and aspirin resulted only in a reduction of thrombus size, whereas a slow streptokinase infusion resulted in complete disappearance of the thrombus after 16 h. A review of the literature shows that late non-obstructive bioprosthetic valve thrombosis, as diagnosed with TEE, is a rare condition that can be successfully treated either by anticoagulant or thrombolytic therapy. Late bioprosthetic valve thrombosis should be considered as a cause of prosthetic valve dysfunction, and longterm preventive anticoagulant treatment of high-risk patients is warranted. Slow thrombolytic therapy is safe and successful, even for large non-obstructive bioprosthetic thrombi, if there are no contraindications.

Original languageEnglish
Pages (from-to)526-530
Number of pages5
JournalJournal of Heart Valve Disease
Volume20
Issue number5
Publication statusPublished - Sep 2011

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Mitral Valve
Thrombosis
Thrombolytic Therapy
Transesophageal Echocardiography
Anticoagulants
Bioprosthesis
Streptokinase
Low Molecular Weight Heparin
Aspirin
Echocardiography
Stroke
Guidelines

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Successful thrombolysis of late, non-obstructive mitral bioprosthetic valve thrombosis: Case report and review of the literature",
abstract = "Bioprosthetic valve thrombosis is an unexpected complication which has no guidelines for its management. A 70-year-old female presented 10 days after a stroke, three years after having undergone mitral bioprosthetic valve implantation. Both, transthoracic echocardiography and transesophageal echocardiography (TEE) revealed a large mobile, non-obstructive mass attached to the atrial side of the sewing ring of the bioprosthesis. The administration of low-molecular-weight heparin and aspirin resulted only in a reduction of thrombus size, whereas a slow streptokinase infusion resulted in complete disappearance of the thrombus after 16 h. A review of the literature shows that late non-obstructive bioprosthetic valve thrombosis, as diagnosed with TEE, is a rare condition that can be successfully treated either by anticoagulant or thrombolytic therapy. Late bioprosthetic valve thrombosis should be considered as a cause of prosthetic valve dysfunction, and longterm preventive anticoagulant treatment of high-risk patients is warranted. Slow thrombolytic therapy is safe and successful, even for large non-obstructive bioprosthetic thrombi, if there are no contraindications.",
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