Successful thrombolysis of prosthetic mitral valve thrombosis in early pregnancy

Prosthetic valve thrombosis occurring during pregnancy is a life-threatenin g complication. Surgical treatment requires clot removal or valve replaceme nt under cardiopulmonary bypass, and carries a high mortality. We report su ccessful thrombolytic therapy with streptokinase for prosthetic valve throm bosis in a pregnant, 28-year-old woman. The patient, who had undergone mitr al valve replacement (St. Jude Medical prosthesis) two years previously for restenosis after closed mitral valvotomy, was successfully thrombolyzed du ring the first trimester (6-8 weeks) for prosthetic valve thrombosis, and w ithout any complication. The patient delivered a normal healthy child at ni ne months' gestation. Although thrombolysis in pregnancy has been reported previously, this is the first case in which it was performed during the fir st trimester for prosthetic valve thrombosis.