Resolution of prosthetic valve stenosis (presumed thrombosis) without thrombolytic therapy or surgical intervention

Waksmonski, Carol A.; Dye, Robert; Riley, Marilyn F.; Berman, Aaron D.

doi:10.1016/0002-9343(90)90393-r

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…In regard to the effect of oral anticoagulants/heparin in thrombus resolution, Oliver et al 17 and Waksmonski et al 22 showed it to be a safe (no complications, such as embolism or bleeding, being observed) and effective alternative with improvement of the functional class in all patients during follow-up. In their study, the treatment with oral anticoagulants was effective in 3 patients, and, 1 patient (receiving intravenous heparin and oral anticoagulation) required the additional thrombolytic treatment for thrombus resolution.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, the descriptions of bioprosthetic mitral valve thrombosis on TEE are rare [13][14][15][16][17] . In regard to the treatment of metallic prosthetic thrombosis, the thrombolytic agent has been efficient in a significant number of cases [18][19][20][21] , although the use of oral anticoagulants prior to the thrombolytic agent has also been effective on some occasions, when one is not dealing with an acute hemodynamic decompensation 22 .…”

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confidence: 99%

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Trombose de prótese biológica mitral: importância do ecocardiograma transesofágico no diagnóstico e acompanhamento pós-tratamento

Parro¹,

Carramona²,

Amaral³

et al. 2004

Arq. Bras. Cardiol.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Trombose de prótese biológica mitral: importância do ecocardiograma transesofágico no diagnóstico e acompanhamento pós-tratamento

Parro¹,

Carramona²,

Amaral³

et al. 2004

Arq. Bras. Cardiol.

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“…We have also compared the incidence of arterial embolizations with the number of embolic events after fibrinolytic therapy of thrombotic tricuspid valves. No events of pulmonary embolism have been reported in these patients [18][19][20]. However, the number of patients with thrombotic tricuspid valves treated with fibrinolytic agents is very small.…”

Section: Discussionmentioning

confidence: 99%

Severe complications following thrombolytic therapy of an acute thrombosis of a prosthetic mitral valve

et al. 1994

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Thrombosis of prosthetic cardiac valves is a rare but potentially lethal complication. As emergency surgical intervention of thrombotic prosthetic cardiac valves is correlated with high mortality, fibrinolytic therapy has been recently recommended as a therapy with high efficacy and no severe side effects. We report on a patient with thrombosis of a prosthetic mitral valve who developed severe embolic complications following the administration of the thrombolytic agent. On admission the patient showed signs of incipient cardiogenic shock. The diagnosis of thrombotic obstruction of the prosthetic mitral valve was confirmed by transesophageal echocardiography. The effective valve area was 0.41 cm2. Pulmonary arterial blood pressure and wedge pressure were significantly elevated. A fibrinolytic therapy with recombinant tissue-type plasminogen activator according to the Neuhaus scheme was attempted. Within 60 min after start of treatment the effective valve area increased (1.41 cm2), and the pulmonary capillary wedge pressure decreased. However, peripheral and cerebral embolism occurred. Occlusion of the right brachial and right femoral artery was ascertained by Doppler ultrasound. Embolism into the right leg made an embolectomy with a Fogarty catheter necessary. Computed tomography revealed two lesions located in the occipital and left temporal area of the brain. Correlated with the lesions evaluated in computed tomography, right hemiplegia and complete aphasia was observed. The neurological status of the patient has only slightly improved to the present. To our knowledge no severe persistent neurological deficits following thrombolytic therapy have been reported. We therefore assume that the risk of severe neurological complications is underestimated.(ABSTRACT TRUNCATED AT 250 WORDS)

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Effect of warfarin on arterial thrombogenesis: Problems of monitoring

et al. 1993

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Platelet reactivity to shear stress and collagen and dynamic overall coagulation were measured in vitro from nonanticoagulated blood of 137 patients on warfarin. One hundred five matched, healthy subjects served as controls. Platelet reactivity to both stimuli and contribution of platelets to plasmatic coagulation were significantly inhibited in patients on warfarin. No correlation was found between platelet reactivity and the coagulation status assessed by the international normalized prothrombin time ratio (INR). Despite similar INR, platelet reactivity showed great individual variation. In 98 patients who were followed up for 3 months, measurement of platelet reactivity to shear stress could discriminate between those who had either bleeding or thromboembolic episodes. These findings suggest that monitored platelet function would help in individualizing oral anticoagulant regimens and hence would increase the benefit of therapy without the risk of bleeding complications.

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Resolution of prosthetic valve stenosis (presumed thrombosis) without thrombolytic therapy or surgical intervention

Cited by 4 publications

References 4 publications

Trombose de prótese biológica mitral: importância do ecocardiograma transesofágico no diagnóstico e acompanhamento pós-tratamento

Trombose de prótese biológica mitral: importância do ecocardiograma transesofágico no diagnóstico e acompanhamento pós-tratamento

Severe complications following thrombolytic therapy of an acute thrombosis of a prosthetic mitral valve

Effect of warfarin on arterial thrombogenesis: Problems of monitoring

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