THROMBOLYTICS AND LEFT-SIDED PROSTHETIC VALVE THROMBOSIS - A CASE-REPORT

Prosthetic valve thrombosis is a well-known condition. Because surgica l treatment of prosthetic valve thrombosis is associated with a high m ortality rate, the use of thrombolysis as therapy for this condition h as gained popularity in recent years. In this article, we discuss the cases of 3 patients who presented to our institution with left-sided p rosthetic valve thrombosis between 1994 and 1997. All 3 patients prese nted with New York Heart Association functional class III or IV sympto ms, and all were successfully treated with urokinase. The use of throm bolytic therapy for left-sided prosthetic valve thrombosis is associat ed with low mortality rates, and therefore is an attractive alternativ e to valve replacement or thrombectomy. However, the risk of embolic a nd hemorrhagic complications precludes the use of thrombolysis in pati ents with large thrombi and in those with New York Heart Association f unctional class I and II symptoms; for these patients, the risk associ ated with thrombolysis exceeds surgical mortality rates.