Why the study?
Stuck valve is a rare, highly lethal complication of mechanical prosthetic valves on oral anticoagulants with significant morbidity and mortality that requires emergency management.
Does thrombolytic therapy with streptokinase improve outcomes in patients with stuck mechanical prosthetic valves?
Does thrombolytic therapy with streptokinase improve outcomes in patients with stuck mechanical prosthetic valves?
Thrombolytic therapy with streptokinase is an effective and relatively safe treatment for stuck mechanical prosthetic valves, achieving high rates of freedom from major complications.
Streptokinase may offer an emergency option for stuck mechanical valves; leaves open the need for randomized trials before practice change.
Background : A stuck valve is the rare, highly lethal complication of mechanical prosthetic valves on oral anticoagulants, associated with signicant morbidity and mortality requiring emergency management. Methods : A prospective observational study was conducted on patients at cardiology department, Prathima institute of medical sciences (Karimnagar), who had recently developed stuck valves and were treated with streptokinase. We studiedResults : patients (n=44) receiving thrombolytic therapy with streptokinase between the period (12/2020 – 03/2022). The patients achieved 93.1% freedom from repeat operations or major complications. Haemorrhagic stroke occurred in two (4.5%) patients, a neurological decit in three (6.8%), an allergic reaction in one (2.25%), and death in one patient during therapy due to refractory cardiogenic shock (2.25%). Mortality was higher in haemodynamically unstable patients compared to those with haemodynamic stability. Thrombolytic therapy with streptokinase is a highly effective and safe treatment inConclusions : haemodynamically stable as well as unstable patients with stuck mechanic prosthetic valves
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Vikranth et al. (2022) studied this question.
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