Key result
Streptokinase successfully resolved aortic prosthetic valve thrombosis in a first-trimester pregnant patient, improving peak trans-aortic velocity from 5.5 m/s to 3.7 m/s without maternal or fetal complications.
Why the study?
Does streptokinase thrombolysis improve clinical and echocardiographic outcomes in a first-trimester pregnant patient with aortic prosthetic valve thrombosis?
Case Report (n=1)
No
Does streptokinase thrombolysis improve clinical and echocardiographic outcomes in a first-trimester pregnant patient with aortic prosthetic valve thrombosis?
Fibrinolytic therapy with streptokinase is a reasonable and successful alternative to surgery for mechanical aortic valve thrombosis in the first trimester of pregnancy.
Answers are grounded in this paper and cite their sources.
Streptokinase may be considered in select first-trimester prosthetic valve thrombosis cases; leaves open need for prospective safety data.
Prosthetic heart valve thrombosis during pregnancy is life-threatening. Standard surgical treatment using cardiopulmonary bypass carries high maternal and fetal complications. Here we report a case of an antenatal female in first trimester with aortic prosthetic valve thrombosis (PVT), who was successfully thrombolysed with streptokinase with no complication to mother or fetus. The aim was to justify the usefulness of thrombolysis as a treatment option for prosthetic valve thrombosis in antenatal patients. A 35-year-old female patient presented in the first trimester of pregnancy with PVT at aortic position. After due consent, thrombolysis was undertaken with streptokinase. During the hospital course, she was followed clinically and with echocardiography. She symptomatically improved with thrombolysis. Transthoracic echocardiography showed complete resolution of thrombus. Peak trans-aortic velocity improved from 5.5 m/s to 3.7 m/s. She delivered a normal baby uneventfully in follow up at full term of pregnancy with no complications. Fibrinolytic therapy for mechanical valve thrombosis is a reasonable alternative to surgery in first trimester of pregnancy.
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Shukla et al. (2015) conducted a case report in Aortic prosthetic valve thrombosis (n=1). Streptokinase was evaluated on Resolution of thrombus and hemodynamic improvement. Streptokinase successfully resolved aortic prosthetic valve thrombosis in a first-trimester pregnant patient, improving peak trans-aortic velocity from 5.5 m/s to 3.7 m/s without maternal or fetal complications.
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