Successful thrombolysis on a mechanical tricuspid prosthesis

Area of Science:

• Cardiology
• Thrombosis Management

Background:

• Recombinant tissue-type plasminogen activator (rt-PA) is a thrombolytic agent primarily used for myocardial infarction.
• Its application in managing thrombotic dysfunction of prosthetic cardiac valves is infrequent and sparsely documented.

Observation:

• A 33-year-old female patient presented with a 2-month history of thrombotic dysfunction of her St Jude Medical prosthesis in the tricuspid position.
• The patient received a 70 mg infusion of rt-PA.

Findings:

• Following rt-PA administration, the prosthetic valve resumed normal function.
• The treatment induced a moderate systemic fibrinolytic state and minor bleeding complications.

Implications:

• This case suggests rt-PA is a viable therapeutic option for prosthetic valve thrombosis.
• Further research is warranted to establish optimal rt-PA protocols for this specific indication.