Thrombolysis for Bileaflet Valve Thrombosis.
10.4326/jjcvs.28.39
- VernacularTitle:二葉弁血栓弁に対する血栓溶解療法の検討
- Author:
Nanritsu Matsuyama
;
Kunio Asada
;
Keiichiro Kondo
;
Toshihiro Kodama
;
Seiichiro Minohara
;
Shigeto Hasegawa
;
Yoshihide Sawada
;
Junko Okamoto
;
Seiji Kinugasa
;
Ken Okamoto
;
Shinjiro Sasaki
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1999;28(1):39-43
- CountryJapan
- Language:Japanese
-
Abstract:
Between January 1981 and December 1996, we performed valve replacement in 281 patients using bileaflet prosthetic valves in mitral and/or tricuspid positions. Thrombosed valve were seen in 10 patients (7 in mitral, 3 in tricuspid positions). In 5 patients, coumadin had been stopped for several reasons (pacemaker implantation, melena, drug allergy), but in the other 5 patients, anticoagulation was within the therapeutic range at the time of presentation. For thrombolytic therapy urokinase or tissue plasminogen activator were used. The treatment was successful in 5 patients (4 mitral, 1 tricuspid), and unsuccessful in 5 patients (3 mitral, 2 tricuspid). Three of the 5 unsuccessful patients were treated surgically (3 with re-mitral valve replacement, 1 with thrombectomy). Prompt surgical treatment can be used as the first line of therapy for thrombosed valves. Thrombolytic therapy may be useful in some cases of bileaflet valve thrombosis without critical hemodynamic collapse. Doppler echocardiographic assessment of increasing peak velocity and pressure half time is useful for detecting thrombosed valves.
