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European Journal of Echocardiography Advance Access published online on February 28, 2009
European Journal of Echocardiography, doi:10.1093/ejechocard/jen336
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Thrombolysis of an acute prosthetic mitral valve thrombosis presented with cardiogenic shock under the guidance of continuous transoesophageal monitoring

Murat Biteker*, Nilüfer Eksi Duran, Sabahattin Gündüz, Tayyar Gökdeniz, Hasan Kaya, Ahmet Çagri Aykan and Mehmet Özkan

Cardiology Department, Kosuyolu Heart and Research Hospital, Istanbul, Turkey

Received 20 August 2008; accepted after revision 22 December 2008.

* Corresponding author. Zeytinlik Caddesi, Emrah Sokak, Mustafa Çiftçi Apt., 7/20, Atalar/Kartal. Tel: +90 2164594041; fax: +90 2164596321. E-mail address: murbit2{at}yahoo.com


  Abstract

Thrombotic occlusion of prosthetic valves continues to be an uncommon but serious complication. Intravenous thrombolytic treatment has been proposed as an alternative to surgical intervention. Due to the lack of a generally accepted standard regimen, various infusion protocols and thrombolytic doses were used for the management of prosthetic heart valve thrombosis. However, rapid thrombolytic infusion, especially in the presence of large thrombus, may increase the risk of embolization. Continuous transoesophageal echocardiography may provide monitoring the efficacy of thrombolysis especially in critically ill patients.

Keywords: Prosthetic heart valve thrombosis; Transoesophageal echocardiography; Thrombolysis


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