Mechanical cardiac valve thrombosis : is fibrinolysis justified ?

Background. Thrombosis is a serious complication of heart valve replacement, and management is often difficult. In recent years, thrombolytic therapy has been used as the primary technique by some investigators. Methods and Results. Sixty-four consecutive patients presenting with 75 instances of prosthetic heartvalve thrombosis (41 mitral, 33 aortic, one tricuspid) were treated with fibrinolytic agents. Obstructed prosthetic valves comprised 39 tilting disc and 36 bileaflet valves. The time interval between valve replacement and obstruction ranged from 15 days to 192 months (mean, 38 months)