Prosthetic valve trhombosis

Abstract Funding Acknowledgements Type of funding sources: None. Background Prosthetic valve thrombosis (DVT) is a very serious complication, with high morbidity and mortality, risk stroke during hospital admission, which occurs especially in patients poorly anticoagulated mechanical prostheses. Therapeutic options available for DVT are surgery, or without prosthetic replacement, intravenous thrombolysis. However, there no randomized study comparing these two interventions. Therefore optional treatment controversial. This also reflected the current clinical practice guidelines international scientific societies year 2017, where American College Cardiology / Heart Association considers surgery thrombolysis as comparable treatments (Class I), On other hand, European Society (ESC) opts leaving only when not available, has cases right thrombosis. Purpose In our center we have used regimen low doses t-PA slow infusion adequates results, proposed by Özkan et al. 25 mg administered over hours, repeating this dose up to resolution maximum 8 times. Methods We reviewed eleven patients, all prostheses, six treated five systemic Of latter, were high-dose accelerated (10 bolus 90 2 hours) three ultra-slow (25 hours). consider normalization mean transvalvular gradients regurgitation insufficiency successful result. The age was 62.6 years time from 84.9 months. Most belonged class III IV NYHA. Anticoagulation subtherapeutic 80% cases. success rate 100%. pattern, one them required second dose. No side effects complications observed. group, died admission result shock state postoperative cardiac output. deceased at months, although related metastatic melanoma. Results observed full DVT, compared surgery. Bolus equally effective resolving logically less bleeding due administration, embolic events having been slower lysis thrombus new follow-up. Conclusion According results low-dose will be initial therapeutic option given safety, cost, efficacy. Figure. valvular Evolution.