Short-Term Clinical Follow-Up After Thrombolytic Therapy in Patients With Prosthetic Valve Thrombosis: A Single-Center Experience

Akshyaya Pradhan, Monika Bhandari, Vikas Gupta, Pravesh Vishwakarma, Rishi Sethi, Varun Shankar Narain, Gaurav Chaudhary, Sharad Chandra, Sudhanshu Dwivedi

Abstract


Background: Thrombolytic therapy has evolved as an alternative to surgery for prosthetic valve thrombosis (PVT). Therefore, this retrospective, single-center study aimed to evaluate the clinical profile of PVT and the role of thrombolytic therapy in patients with PVT.

Methods: Data from a total of 16 consecutive patients with PVT enrolled between January 2017 and January 2018 at a tertiary care center in India were retrospectively evaluated. PVT was diagnosed based on clinical presentation, transthoracic echocardiography, and fluoroscopy. All patients received 0.25 MU intravenous (IV) bolus streptokinase over 30 min, followed by a 0.1 MU/h IV infusion for a maximum of 72 h. Transthoracic echocardiography and fluoroscopy were repeated after completion of thrombolysis session. The clinical endpoints were death and hemodynamic success within 24 h of thrombolytic therapy or during the hospital stay, and major complications, including stroke or major bleeding (intracranial bleed or bleeding requiring transfusion or surgical treatment) during the hospital stay and within 3 months of thrombolytic therapy.

Results: The median age of the patients was 40 ± 11.60 years and about 62.5% (n = 10) were females. The median time between the valve placement and presentation for PVT was 3 years (range: 1 - 4 years). The peak gradient across the thrombotic mitral and aortic valve was 43.79 ± 18.47 and 93.5 ± 33.11 mmHg, respectively. At 3 days post-thrombolysis, peak gradient across both mitral valve (15.91 ± 7.56; mean gradient: 8.45 ± 4.01) and aortic valve (23.50 ± 6.45; mean gradient: 13.60 ± 3.83) decreased significantly (P ≤ 0.05). The thrombolytic therapy was successful in 13 (81.25%) patients. While, two (12.50%) patients died, none developed stroke or myocardial infarction during the study period.

Conclusions: The present study with short-term follow-up demonstrated the acceptable clinical efficacy of thrombolytic therapy. However, larger trials with a greater number of patients and longer follow-up are warranted to establish the safety and effectiveness of thrombolytic therapy in patients with PVT.




Cardiol Res. 2019;10(6):345-349
doi: https://doi.org/10.14740/cr924


Keywords


Prosthetic valve thrombosis; Thrombolytic therapy; Streptokinase

Full Text: HTML PDF
 

Browse  Journals  

     

Journal of clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 

 

 

 

Cardiology Research, bimonthly, ISSN 1923-2829 (print), 1923-2837 (online), published by Elmer Press Inc.        
The content of this site is intended for health care professionals.

This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.cardiologyres.org   editorial contact: editor@cardiologyres.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.