[Successful thrombolysis of a thrombosed mitral valve prosthesis]

Thrombosis of a cardiac valve prosthesis is a rare but life-threatening event. The diagnosis may be suspected clinically and verified by Doppler echocardiography and/or fluoroscopy. Thrombolysis is being increasingly used as an alternative to emergency surgery (thrombectomy or prosthesis replacement). We describe the clinical course of successful thrombolysis of a thrombosed double leaflet Carbomedics No 29 prosthesis in mitral position, using urokinase, in an elderly female presenting with severe NYHA class IV dyspnea. Thrombolysis should be considered as a first line of treatment for thrombosed cardiac valve prostheses. The addition of a platelet inhibitor is warranted in patients with an episode of prosthetic cardiac valve thrombosis under adequate oral anticoagulation.