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October 7, 2025CureusOpen Access

Tenecteplase resolves aortic prosthetic thrombosis and cuts transvalvular gradient by 33 mmHg in one patient.

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Why the study?

While surgery is standard for prosthetic valve thrombosis, thrombolysis has emerged as an alternative in patients with high surgical risk or surgical refusal.

Does intravenous thrombolysis with tenecteplase improve valve function and clinical status in a patient with obstructive prosthetic valve thrombosis?

Population

One 38-year-old woman with obstructive aortic mechanical prosthetic thrombosis and embolic STEMI refusing surgery

Design

Case report

Key result

Intravenous thrombolysis with tenecteplase successfully restored prosthetic valve function and reduced the transvalvular gradient from 56 to 23 mmHg in a patient with obstructive aortic prosthetic thrombosis.

Authors

MLM. LebbarFMFatimazahra MerzoukMBMohamed Ghali Benouna

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Overview

Thrombolysis offers a viable option for prosthetic valve thrombosis patients refusing surgery; extends RCT evidence to high-risk nonsurgical candidates.

Study Design

Type

Case Report (n=1)

Structured PICO

Does intravenous thrombolysis with tenecteplase improve valve function and clinical status in a patient with obstructive prosthetic valve thrombosis?

P
Population
A 38-year-old woman with obstructive aortic prosthetic valve thrombosis complicated by pulmonary edema and embolic STEMI, treated with thrombolysis and followed for 3 months.
I
Intervention
Intravenous thrombolysis with tenecteplase (10 mg bolus + 90 mg infusion over 90 minutes) plus unfractionated heparin and diuretics.
O
Outcome
Normalization of prosthetic sounds, gradient reduction on echocardiography, and restoration of leaflet mobility on fluoroscopy.surrogate

Thrombolysis with tenecteplase is a feasible and effective alternative to surgery for obstructive prosthetic valve thrombosis in selected patients, even when complicated by embolic STEMI.

Limitations

  • As a single case, it should be viewed as hypothesis-generating rather than conclusive.
  • Single case, should be viewed as hypothesis-generating rather than conclusive

Cite This Study

Lebbar et al. (2025) conducted a case report in Prosthetic valve thrombosis (n=1). Tenecteplase was evaluated on Transvalvular gradient reduction and restoration of valve mobility. Intravenous thrombolysis with tenecteplase successfully restored prosthetic valve function and reduced the transvalvular gradient from 56 to 23 mmHg in a patient with obstructive aortic prosthetic thrombosis.

synapsesocial.com/papers/6a2aea6db98b30614224920bhttps://doi.org/10.7759/cureus.94043
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