Effective Ultraslow Low-Dose Thrombolysis for Aortic Bioprosthetic Valve Thrombosis

Bioprosthetic valve thrombosis (BPVT) is rare, with an incidence of 0.2% to 6.0%. It often presents as heart failure, thromboembolism, or a new murmur. Diagnosis relies on transthoracic and transesophageal echocardiography, with treatment traditionally being surgical. We report a 74-year-old patient with valvular and Chagas-related heart disease who developed BPVT of the aortic valve. Owing to high surgical risk and lack of response to heparin, ultraslow low-dose thrombolysis was performed, achieving a successful outcome. The emerging therapies for BPVT have a lower risk of mortality when compared with surgical management. Although to our knowledge there are no studies regarding the use of ultraslow low-dose thrombolysis on patients with aortic BPVT, this case demonstrates the safety and efficacy of this approach.