Short- and Long-Term Outcomes of Thrombolytic Therapy for Prosthetic Valve Thrombosis

Abstract

Objective: To assess the efficacy of thrombolytic therapy in achieving favorable short-term and long-term outcomes

Place: Pervaiz Ellahi Institute of Cardiology, Bahawalpur, Pakistan

Methodology: A total of 137 patients with left-sided obstructive prosthetic valve thrombosis (PVT) participated in the study, conducted from [start date] to [end date]. Patients were treated with thrombolytic therapy following specified infusion protocols. Serial Echo Doppler evaluations were performed to monitor the therapy's efficacy. Survivors were followed up for a mean duration of 31.3 ± 27.8 months.

Results: A total of 130 patients of both genders were included in this study. The patients were categorized into three groups: mitral valve replacement (n=78), aortic valve replacement (n=47), and double valve replacement (n=5). The incidence of prosthetic valve thrombosis was recorded as follows: 2 cases (2.6%) in the mitral valve group, 2 cases (4.3%) in the aortic valve group, and none (0%) in the double valve group. Complications were observed in 33 patients (42.3%) in the mitral valve group and 24 patients (51.1%) in the aortic valve group.

Conclusion: Thrombolytic therapy is effective in most patients with prosthetic valve thrombosis (PVT), but it is associated with an increased risk of embolism, particularly in those with atrial fibrillation. The success of PVT treatment does not appear to be influenced by factors such as NYHA classification, symptom duration, or other variables. However, the recurrence rate of PVT is notably higher in patients with atrial fibrillation, even after successful therapy.