ArticleJournal of cardiothoracic surgery2020
Thrombolytic treatment of prosthetic valve thrombosis: a study using Urokinase.
Article in Journal of cardiothoracic surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 13 citations in OpenAlex.
- Redo surgery outcomes for obstructed replaced valve: a single-center experience.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025Article
- Thrombolysis for Cardiogenic Shock Secondary to Aortic Bioprosthetic Valve-in-Valve Thrombosis.Cureus · 2022Article
- Mechanical Aortic Valve Thrombosis Successfully Treated With Intravenous Thrombolytic Therapy: A Case Report.Cureus · 2022Article
- Time to Thrombolysis and Outcomes in Patients with Left-sided Prosthetic Valve Thrombosis: Is Thrombolysis Worth Beyond 7 Days?Heart views : the official journal of the Gulf Heart AssociationArticle
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe analysed the efficacy and safety of thrombolytic therapy with urokinase in patients with prosthetic valve thrombosis.
methodsTwenty-three patients with valve thrombosis received thrombolytic treatment using urokinase. First, a 250,000 IU intravenous bolus injection was administered as a loading dose, followed by intravenous infusion of 100,000 IU/h for 10 h and anticoagulation with low molecular weight heparin every day. The maximum treatment time was 5 days, i.e., until the transvalvular pressure gradient was normal or close to normal. Transthoracic echocardiography (TTE) was used every 12 h to monitor whether the thrombus was reduced and whether there was haemodynamic improvement. Routine blood tests, the prothrombin time (PT), international normalized ratio (INR) and complications were observed every day.
resultsSixteen (69.6%) patients were successfully treated with thrombolytic therapy: 2/2 (100%) aortic valves and 14/21 (66.7%) mitral valves. The partial success rate of this study was 13.0% (3/23). Four patients did not show any improvement in haemodynamics. Two cases had slight urine haemorrhage. One patient died of severe cerebral haemorrhage and shock. The overall mortality was 13.0% (3/23), including two patients who died after subsequent surgery.
conclusionUrokinase is more convenient and successful in the treatment of PVT. More experience may make TT the optimal treatment for PVT, especially in high-risk surgical situations.
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