Prosthetic heart valve thrombosis treated with low-dose slow-infusion fibrinolytic therapy

Thromboembolic complications following heart valve replacements are rare but a severe situation. Cerebral infarcts, transient neurologic deficits, and cardiac arrest due to stuck prostheses are among possible critical outcomes. Diagnosis and appropriate treatment should be initiated rapidly. Echocardiography plays a significant role in diagnosis. Fibrinolysis, anticoagulation with heparin, and surgical intervention are considered among the treatment modalities. Medical treatment is conducted according to the valvular condition and the clinical status of the patient. In order to prevent probable complications and enhance the efficiency of fibrinolysis, different approaches have been established regarding the dose and rate of the medication. In the present case, we report a prosthetic heart valve thrombosis successfully treated with an administration of low-dose, slow-infusion fibrinolytic agent. <Learning objective: Valvular thrombotic complications after heart valve replacement operations are associated with high morbidity and mortality. Efficient and urgent treatment is necessary. Considering the medical treatment, popular conviction about fibrinolytic therapy has depended on the principal of 'the more, the better' to date. However, complications of the fibrinolysis may aggravate hemorrhagic complications with high doses. In this case report, we aimed to state that low-dose slow-infusion thrombolysis is as efficient as higher doses with fewer complications.>.