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June 27, 2025European Heart Journal24 citations

Urgent surgery vs fibrinolytic therapy for left-sided prosthetic valve thrombosis: a randomized trial

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GKGanesan KarthikeyanPRPalleti RajashekarNDNiveditha Devasenapathy

Structured PICO

Does urgent surgery improve efficacy or reduce complications compared to fibrinolytic therapy in patients with symptomatic left-sided prosthetic valve thrombosis?

P
Population
Patients with symptomatic left-sided prosthetic valve thrombosis (PVT)
I
Intervention
Urgent surgery
C
Comparator
Fibrinolytic therapy (FT)

In symptomatic left-sided prosthetic valve thrombosis, fibrinolytic therapy may offer a safer alternative to urgent surgery, avoiding higher mortality and complication risks despite a greater chance of residual valve dysfunction.

Abstract

In symptomatic left-sided PVT, urgent surgery is not more efficacious than FT. Surgery is associated with a higher risk of complications, including death, while FT is more often associated with residual valve dysfunction.

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Cite This Study

Karthikeyan et al. (2025) studied this question.

synapsesocial.com/papers/69d437d10a6874f46ce109a2https://doi.org/10.1093/eurheartj/ehaf391
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Surgery compared to fibrinolytic therapy for symptomatic left-sided prosthetic heart valve thrombosis (SAFE-PVT): Rationale and design of a randomized controlled trial2024 · 2 citations
  2. 2Urgent surgery compared with fibrinolytic therapy for the treatment of left-sided prosthetic heart valve thrombosis: a systematic review and meta-analysis of observational studies2013 · 132 citations
  3. 3Thrombolysis or Surgery in Patients With Obstructive Mechanical Valve Thrombosis2022 · 75 citations
  4. 4Management of Mechanical Prosthetic Heart Valve Thrombosis2023 · 72 citations
  5. 5Accelerated Infusion of Streptokinase for the Treatment of Left-Sided Prosthetic Valve Thrombosis2009 · 84 citations