THROMBOLYTIC THERAPY WITH RECOMBINANT TIS SUE-TYPE PLASMINOGEN-ACTIVATOR (RT-PA) FOR THROMBOSIS OF A TRICUSPID-VALVE PROSTHESIS DURING PREGNANCY

The authors report the case of a woman with thrombosis of a tricuspid Saint Jude prosthesis during the fourth month of pregnancy. A first co urse of thrombolytic therapy with rt-PA reestablished normal prostheti c valve function but was followed by a threatened abortion and severe uterine haemorrhage. An early rethrombosis of the prosthetic valve led to interruption of the pregnancy after failure of a second course of thrombolysis, and to replacement of the tricuspid valve prosthesis. Th is case illustrates the problems of pregnancy in women with mechanical cardiac prosthetic valves and the difficulties of treatment.