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Updated: Jan 15, 2026

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
Prosthetic Valve Thrombosis: Fibrinolysis, Surgery, or Percutaneous Manipulation?
Shankar Machigar1, Satyavan Sharma2, Anil Sharma2
1Senior Resident, Department of Cardiology, Bombay Hospital and Medical Research Center, Mumbai, Maharashtra, India, Corresponding Author.
Abstract:
A total number of 20 cases of prosthetic valve thrombosis (PVT) involving left-sided bileaflet St Jude's prosthesis (16), Medtronic Hall (3), and pulmonary prosthesis (1) are reported. Streptokinase (STK) fibrinolysis provided excellent results in 66.6% of cases with thrombosed St Jude's mitral prosthesis and remains the preferred option for this subset. Percutaneous manipulation of the mitral disk proved a useful adjuvant. Reteplase produced gratifying results in pulmonary mechanical prosthesis. However, thrombosed aortic prosthesis responded unfavorably to fibrinolysis. About six patients who failed to respond to thrombolysis had excellent results with valve replacement surgery. Two patients (10%) succumbed due to extremely high-risk clinical characteristics.
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