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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Huge prosthetic mitral valve thrombus: use of serial transesophageal echocardiography guidance in resolution

Nihal Ozdemir1, Cihangir Kaymaz, Mehmet Ozkan

  • 1Kosuyolu Heart & Research Hospital, Department of Cardiology, Kadköy, Istanbul, Turkey.

The Journal of Heart Valve Disease
|February 13, 2003
PubMed

The case is presented of a 35-year-old woman with major thrombotic obstruction of a 29-mm St. Jude Medical mitral valve prosthesis. The thrombi were treated with successive intravenous fibrinolysis under transesophageal echocardiographic guidance, without complication. One large and obstructive thrombus with a long and mobile component, and other smaller and mobile thrombi were detected. These were gradually lysed after two successive administrations of streptokinase (1.5 x 10(6) units over 24 h), and one session of recombinant tissue type plasminogen inhibitor (100 mg over 6 h).

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