Thrombolytic treatment of acute thrombotic obstruction with disk valve prostheses: experience with 26 cases

Twenty-eight episodes of prosthetic valve thrombosis occurred in 26 patients, and all were treated by thrombolytic drugs. The treatment consisted of UK (4500 IU/kg/hr for 12 hours) or SK (2,000,000 IU over 10 hours). The results were followed clinically and in the laboratory and by the same methods that are used for the diagnosis (echocardiography, fluoroscopy) of these problems. Immediate complete regression was seen in 23 cases. These cases did not undergo cardiac surgery. In three cases, in which clear clinical improvement was obtained while both the echocardiography and cinefluoroscopy showed persistent valve dysfunction, the patients were treated medically in two cases (second thrombolysis) and by surgery in one case. In two other cases thrombolysis was ineffective and the patients underwent emergency valve replacement. There were no significant hemorrhagic complications, but emboli from the thrombolysis occurred in five patients. Laboratory data illustrated changes in the success and improvement groups. There were no changes in the failure group.