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[Repeated thrombolysis and difficulties in treatment with antivitamin K in an infant with mitral valve prosthesis]

H Lucron1, F Marçon, G Bosser

  • 1Service de cardiologie infantile, CHU de Nancy, hôpital d'enfants, Vandoeuvre-lès-Nancy.

Archives Des Maladies Du Coeur Et Des Vaisseaux
|May 1, 1995
PubMed

Insights

Congenital mitral regurgitation in an infant required valve replacement. Subsequent prosthetic valve thrombosis was successfully treated with thrombolysis, highlighting challenges with infant anticoagulation.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Neonatal Medicine

Background:

  • Congenital mitral regurgitation can lead to neonatal cardiac failure.
  • Surgical intervention for pediatric valve disease is complex.
  • Prosthetic valve thrombosis is a serious complication in infants.

Observation:

  • A neonate with congenital mitral regurgitation underwent mitral valve replacement at 4 months.
  • The child experienced four episodes of prosthetic valve thrombosis within two years.
  • Initial treatment included surgical intervention and subsequent thrombolysis.

Findings:

  • Three out of four thrombotic events were successfully treated with thrombolysis (tissue plasminogen activator and urokinase).
  • Thromboses often occurred despite heparin and oral anticoagulant therapy, especially during therapy destabilization.
  • Repeat thrombolysis demonstrated efficacy, expanding its potential use in infants.

Implications:

  • Thrombolysis can be a viable treatment for prosthetic valve thrombosis in infants.
  • Managing oral anticoagulation in infants presents significant challenges.
  • This case underscores the need for careful monitoring and tailored anticoagulation strategies in pediatric patients with prosthetic valves.

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