ARYA Atherosclerosis Journal

Fibrinolytic Therapy in Thrombosis of Mechanical Valves: Outcomes and Complications

Document Type : Original Article

Authors

Ali Nasri Nasrabadi 1
Fahime Yarhamadi 2
Afshin Amirpour 3
Reihane Zavar 4
Mojtaba Akbari 5

1 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

2 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

4 Department of Cardiology ,Chamran Cardiovascular and Medical Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

5 Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran

https://doi.org/10.48305/arya.2023.26569.2804
Abstract
INTRODUCTION: Valvular heart disease presents a significant and escalating global health challenge. Prosthetic valve thrombosis (PVT) following surgical valve replacement is a primary cause of valve failure. The aim of this study was to ascertain the outcomes and complications of fibrinolytic therapy in patients diagnosed with PVT.
METHOD: This cross-sectional study enrolled 81 patients diagnosed with PVT who underwent fibrinolytic therapy between 2008 and 2018. Streptokinase was administered to 87.6% of patients, while 12.4% received reteplase. All demographic and clinical data were gathered from the patients’ medical records. The incidence of successful recovery and complications were assessed.
RESULTS: The records of 81 patients (43.2% male, mean age: 51.6 ± 13.9 years) were examined. The findings revealed that 59% and 35% of the patients had mitral and aortic PVT, respectively. While 12% of the patients experienced drug complications, 90% achieved successful recovery. Stroke and severe hemorrhage were complications frequently reported by the patients treated with streptokinase (8% and 4% respectively). The patients treated with reteplase demonstrated a 100% recovery rate. Conversely, 89% of the patients treated with streptokinase achieved successful recovery, and 7% of the patients experienced a partial recovery.
CONCLUSION: Fibrinolytic agents can serve as an effective treatment with an excellent success rate for managing PVT in patients post-surgical valve replacement.
 

Keywords

Prosthetic valve thrombosis
Fibrinolytic therapy
Streptokinase
Reteplase
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ARYA Atherosclerosis Journal
Volume 19, Issue 5
September and October 2023
Pages 18-24

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