NOW YOU SEE ME, NOW YOU DON'T: HIGH-DOSE TISSUE PLASMINOGEN ACTIVATOR FOR MECHANICAL MITRAL VALVE THROMBOSIS AND CARDIOEMBOLIC MYOCARDIAL INFARCTION IN THE SETTING OF CATASTROPHIC ANTIPHOSPHOLIPID ANTIBODY SYNDROME

Mechanical heart valve thrombosis (MHVT) is rare but can lead to life threatening complications. Low-dose ultraslow tissue plasminogen activator (tPA) infusion is being used for treatment of MHVT as an effective alternative to surgery. There is however no guidance on management of MHVT in the