Key result
A 30-year-old male with prosthetic mitral valve thrombosis developed a saddle thrombus at the aortic bifurcation following thrombolytic therapy with streptokinase, requiring thrombectomy.
Why the study?
Prosthetic cardiac valve thrombosis is a dangerous complication where thrombolytic therapy is widely used due to surgical risks and lack of rural surgical expertise, but awareness of embolic complications is needed.
Case Report (n=1)
No
While thrombolytic therapy is an effective alternative to surgery for prosthetic valve thrombosis in resource-limited settings, it carries a significant risk of severe systemic embolic complications requiring prompt vascular intervention.
Saddle embolus after streptokinase for prosthetic valve thrombosis warrants clinical vigilance; leaves open optimal therapy selection in resource-limited settings.
Prosthetic cardiac valve thrombosis is a rare but dangerous complication; 1,2 particularly in patients with low conformity on anticoagulant therapy. Thromboembolic problems happen after mechanical valve substitution in 0.5 - 8 percent. 3-5 Fibrinolytic therapy to treat the thrombosis is widely used nowadays with high efficacy and no severe side effects as compared to emergency surgical treatment, which is associated with high mortality.6 Surgical valve repair in patients with rheumatic heart disease remains the gold standard for the treatment. Thrombosis of the prosthetic heart valve in patients undergoing valve replacement, is the most severe and deadly complication. Currently, the treatments available for symptomatic prosthetic valve thrombosis are immediate surgery or thrombolytic therapy (TT). In rural hospital settings patients are poor and there is a lack of surgical expertise. These factors make TT the perfect treatment for prosthetic valve thrombosis. But one should be aware of embolic complications.
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Husain et al. (2021) conducted a case report in Prosthetic Mitral Valve Thrombosis (n=1). Streptokinase was evaluated. A 30-year-old male with prosthetic mitral valve thrombosis developed a saddle thrombus at the aortic bifurcation following thrombolytic therapy with streptokinase, requiring thrombectomy.
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