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Urokinase therapy for thrombosis of tricuspid prosthetic valve
Insights
A pediatric patient with complex heart defects experienced thrombus formation after a mechanical valve replacement. Urokinase infusion successfully dissolved the clot, restoring normal valve function and highlighting a treatment option for valve thrombosis in children.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Hematology
Background:
- Congenital heart defects, including pulmonic stenosis and hypoplastic right ventricle, often require complex surgical interventions.
- Tricuspid valve disease in pediatric patients necessitates valve replacement, with mechanical valves being a common choice.
Observation:
- A 16-month-old child with pre-existing heart conditions underwent tricuspid valve replacement with a St. Jude Medical valve.
- Post-operatively, the patient developed thrombus formation on the mechanical valve despite aspirin therapy, leading to valve dysfunction.
Findings:
- Thrombus formation on a mechanical tricuspid valve in a pediatric patient resulted in significant valve dysfunction.
- Intravenous urokinase infusion was effective in dissolving the thrombus and restoring normal mechanical valve function.
Implications:
- This case highlights the potential complication of mechanical valve thrombosis in pediatric patients, even with anticoagulation.
- Urokinase therapy can be a successful treatment for mechanical valve thrombosis in children, avoiding reoperation.
Abstract:
A 16-month-old child was born with pulmonic stenosis and a hypoplastic right ventricle. After palliative procedures, the patient began having signs of tricuspid insufficiency and stenosis necessitating a tricuspid valve replacement. A St. Jude Medical valve was implanted. While the child was on aspirin therapy, thrombus formation resulted in valve dysfunction. This thrombus was successfully dissolved with urokinase infusion, and normal valve function was restored.