Key result
Tenecteplase successfully achieved complete thrombolysis and restoration of prosthetic mitral valve function with no complications in a 44-year-old man.
Case Report (n=1)
No
Tenecteplase administered as a slow continuous infusion successfully treated prosthetic mitral valve thrombosis without hemorrhagic or embolic complications.
May support tenecteplase in select prosthetic valve thrombosis cases; hypothesis-generating and should not change practice without controlled trials.
INTRODUCTION: Prosthetic valve thrombosis is a rare but life-threatening condition that requires careful evaluation and prompt treatment. While surgical intervention remains the gold standard, thrombolytic therapy is now emerging as a potential substitute. Various thrombolytic treatments including streptokinase, urokinase and recombinant tissue plasminogen activators have been reported with variable success rates. However, the data on the use of tenecteplase (a synthetic tissue plasminogen activator) is limited. CASE PRESENTATION: A 44-year-old Middle Eastern man with a previously implanted prosthetic mitral valve presented with exertional dyspnea and orthopnea. Investigations revealed a thrombosed prosthetic mitral valve. Successful thrombolysis was achieved using tenecteplase which lead to the complete restoration of valve function with no risk to the patient. CONCLUSION: Prosthetic valve thrombosis is a rare but life threatening condition, the diagnosis of which requires a high index of suspicion. Tenecteplase can be used successfully in the management of such cases. It has proved to be useful with no extra risk to the patient.
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Al-Sarraf et al. (2010) conducted a case report in Prosthetic mitral valve thrombosis (n=1). Tenecteplase was evaluated on Restoration of valve function and thrombus resolution. Tenecteplase successfully achieved complete thrombolysis and restoration of prosthetic mitral valve function with no complications in a 44-year-old man.
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