Thrombolysis of prosthetic tricuspid valve thrombosis with human recombinant tissue plasminogen activator in an adolescent

Prosthetic heart valve thrombosis is associated with a high mortality. Trad itionally, thrombectomy or valve replacement is performed. Thrombolysis off ers a promising alternative to surgery. Usually, streptokinase and urokinas e are the preferred agents for thrombolysis; however, human recombinant tis sue plasminogen activator (rt-PA) is increasingly used. Thrombosis of prost hetic valves in children and adolescents is rare and experience of thrombol ysis for obstructed valves is limited. We report the successful lysis of a thrombosed prosthetic tricuspid valve in an adolescent using rt-PA. The out come of our patient supports the assumption that rt-PA represents an adequa te therapeutic option for thrombolysis of obstructed prosthetic heart valve s in children and adolescents.