tailieunhanh - Báo cáo y học: "Successful thrombolysis of a thrombosed prosthetic mitral valve using a synthetic tissue plasminogen activator: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Successful thrombolysis of a thrombosed prosthetic mitral valve using a synthetic tissue plasminogen activator: a case report. | Al-Sarraf et al. Journal of Medical Case Reports 2010 4 241 http content 4 1 241 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Successful thrombolysis of a thrombosed prosthetic mitral valve using a synthetic tissue plasminogen activator a case report 1 1 1 2 Nael Al-Sarraf Fahad Al-Shammari Jamal Al-Fadhli Emad Al-Shawaf Abstract Introduction Prosthetic valve thrombosis is a rare but life-threatening condition that requires careful evaluation and prompt treatment. While surgical intervention remains the gold standard thrombolytic therapy is now emerging as a potential substitute. Various thrombolytic treatments including streptokinase urokinase and recombinant tissue plasminogen activators have been reported with variable success rates. However the data on the use of tenecteplase a synthetic tissue plasminogen activator is limited. Case presentation A 44-year-old Middle Eastern man with a previously implanted prosthetic mitral valve presented with exertional dyspnea and orthopnea. Investigations revealed a thrombosed prosthetic mitral valve. Successful thrombolysis was achieved using tenecteplase which lead to the complete restoration of valve function with no risk to the patient. Conclusion Prosthetic valve thrombosis is a rare but life threatening condition the diagnosis of which requires a high index of suspicion. Tenecteplase can be used successfully in the management of such cases. It has proved to be useful with no extra risk to the patient. Introduction Prosthetic valves thrombosis PVT is defined as any obstruction of the prosthesis by non-infective thrombotic material. The diagnosis of PVT is made by a combination of clinical data heart failure absence of prosthetic sounds cardiogenic shock and echocardio-grapy. The traditional treatment for PVT is surgery with either thrombectomy or replacement of the prosthesis. In recent years thrombolytic therapy has evolved as a substitute to surgery. Various thrombolytic .