Key result
Intravenous infusion of 50 mg alteplase over 8 hours successfully normalized mechanical mitral valve leaflet motion and reduced the mitral gradient from 26/14 mmHg to 6/4 mmHg.
Why the study?
Does slow intravenous infusion of alteplase improve mechanical mitral valve thrombosis in a high-risk patient?
Case Report (n=1)
No
Does slow intravenous infusion of alteplase improve mechanical mitral valve thrombosis in a high-risk patient?
Slow infusion of alteplase successfully resolved mechanical mitral valve thrombosis and improved hemodynamics in a high-risk patient, though complicated by peripheral bleeding.
May support slow alteplase infusion for stuck mitral prosthesis; hypothesis-generating and should not yet change practice.
Obstructive valve thrombosis after prosthetic valve replacement is a life-threatining problem.Immediate medical or surgical intervention may be life-saving in such clinical cases.In this study we presented a 55-year-old male patient who admitted to our hospital with the complaint of effort dyspnea due to thrombus on single leaflet of mechanical mitral valve. It is still a question whether surgical treatment or thrombolytic therapy should be first choice in this situation. Although serious complications of thrombolytic therapy, we suppose that in high-risk patients with isolated mechanical valve thrombus, successful results can be achieved by applying slow rate infusion of thrombolytic agents.
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Ecevit et al. (2018) conducted a case report in Mitral Valve Thrombosis (n=1). Alteplase was evaluated on Mitral gradient and leaflet motion. Intravenous infusion of 50 mg alteplase over 8 hours successfully normalized mechanical mitral valve leaflet motion and reduced the mitral gradient from 26/14 mmHg to 6/4 mmHg.
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