Successful thrombolytic therapy using ultraslow low-dose infusion during pregnancy for mitral mechanical valve thrombosis: a case series and review of the literature
  • Leila Bigdelu
    Division of Cardiovascular Medicine, Vascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  • Ossama Maadarani
    Critical Care Unit, Internal Medical Department, Ahmadi Hospital-Kuwait Oil Company, Kuwait
  • Asal Yadolh
    Department of Cardiovascular Disease, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  • Zouheir Bitar
    Critical Care Unit, Internal Medical Department, Ahmadi Hospital-Kuwait Oil Company, Kuwait
  • Nadia Azadi
    Division of Cardiovascular Medicine, Vascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Keywords

pregnancy, mechanical valve, thrombosis, thrombolytic therapy

Abstract

According to the modified World Health Organization (WHO) classification, pregnant women with mechanical valves face a very high risk of complications (Risk Category III). Mechanical valve thrombosis is a serious complication that significantly increases during pregnancy due to multiple mechanisms. Thrombolytic therapy has recently been used as a first-line treatment for mechanical valve thrombosis during pregnancy. However, the consensus regarding the optimal treatment strategy, type, dose and route of administration was unclear. We present three cases of mechanical mitral valve thrombosis during pregnancy treated successfully with repeated doses of ultraslow infusion of low-dose tissue-type plasminogen activator (t-PA) alteplase. We also present a review of the literature on this subject.

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    Published: 2023-04-07
    Issue: 2023: Vol 10 No 5 (view)


    How to cite:
    1.
    Bigdelu L, Maadarani O, Yadolh A, Bitar Z, Azadi N. Successful thrombolytic therapy using ultraslow low-dose infusion during pregnancy for mitral mechanical valve thrombosis: a case series and review of the literature. EJCRIM 2023;10 doi:10.12890/2023_003856.

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