Key result
Ultraslow alteplase restores mechanical mitral valve function in a patient with prosthetic valve thrombosis.
Why the study?
Prosthetic valve thrombosis is a rare, serious complication with significant morbidity and mortality, requiring prompt diagnosis and appropriate management with fibrinolytic protocols.
Case Report (n=1)
No
Slow-infusion, low-dose thrombolytic therapy with alteplase can be a life-saving intervention with a high success rate for mechanical mitral valve prosthesis thrombosis.
Supports further evaluation of ultraslow alteplase in prosthetic valve thrombosis; hypothesis-generating and should not yet change practice.
Background: A rare but serious complication of heart valve replacement, prosthetic valve thrombosis carries significant risks of morbidity and mortality. Effective management depends on prompt diagnosis and the appropriate treatment, often involving fibrinolytic agents. Protocols using slower infusion rates and lower doses of these agents have led to improved therapy outcomes. Clinical case: We report a case of a 56-year-old man admitted to the Lithuanian University of Health Sciences Kaunas Clinics due to mechanical mitral valve prosthesis thrombosis complicated by a respiratory failure and atrial fibrillation. The patient was treated with ultraslow thrombolysis with alteplase. The function of the mechanical valve prosthesis became normal, and the patient was discharged from the hospital. Discussion and Conclusions: Managing prosthetic valve thrombosis is challenging due to overlapping clinical features with other diagnoses and the lack of consensus on the treatment methods. Slow-infusion, low-dose thrombolytic therapy with alteplase can be a life-saving intervention with a high success rate.
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Pareikaitė et al. (2025) conducted a case report in Mechanical mitral valve prosthesis thrombosis (n=1). Alteplase was evaluated on Restoration of mechanical valve prosthesis function. Ultraslow thrombolysis with alteplase successfully restored normal mechanical mitral valve prosthesis function in a 56-year-old man with prosthetic valve thrombosis.
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