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Thrombolysis in dysfunctional valve and stroke

Dormar David Barrios-Martínez1,2,3, Yuri Valentina Pinzon4, Veronica Giraldo5

  • 1Department of Critical Care, Hospital Universitario San Vicente Fundación, Medellin 050010, Antioquia, Colombia.

World Journal of Critical Care Medicine
|June 10, 2025
PubMed

Insights

Prosthetic heart valve malfunction can cause stroke. Prompt diagnosis and treatment, including systemic thrombolysis, can restore valve function and improve patient outcomes in critical care settings.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Critical Care Medicine

Background:

  • Valvular heart disease impacts over 100 million globally, with prevalence increasing with age.
  • Mitral regurgitation and aortic stenosis are common, often requiring surgical valve replacement.
  • Prosthetic heart valves can develop complications during peri-procedural or long-term follow-up.

Observation:

  • A 71-year-old female with a history of mitral valve replacement presented with ischemic stroke.
  • The patient's mitral prosthesis showed disc malfunction, suspected to be a microthrombotic lesion.
  • Systemic thrombolysis was administered to address the suspected microthrombus.

Findings:

  • The mitral prosthesis disc function normalized after systemic thrombolysis.
  • The patient experienced reperfusion following the intervention.
  • This suggests a potential link between prosthetic valve thrombosis and embolic events.

Implications:

  • Highlights the importance of considering prosthetic valve dysfunction in stroke etiology.
  • Emphasizes the critical role of a multidisciplinary team in managing complex cardiac cases.
  • Demonstrates the efficacy of systemic thrombolysis in specific prosthetic valve complications.
Abstract

Keywords:
Heart valve diseaseMitral valve thrombolysisProsthetic valve-associated thrombosisRecombinant human plasminogen tissue activatorStrokeThrombotic dysfunction

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