How to perform and manage low-dose and slow/ultra-slow tissue type plasminogen activator infusion regimens in patients with prosthetic valve thrombosis
Citation
Güner, A., Kalçık, M., Gürsoy, M. O., Gündüz, S., Özkan, M. (2018). How to perform and manage low-dose and slow/ultra-slow tissue type plasminogen activator infusion regimens in patients with prosthetic valve thrombosis. Journal of Thrombosis and Thrombolysis, 46(3), 399-402.Abstract
Over the last two decades, thrombolytic therapy (TT) has become an alternative to surgery as a first-line therapy in patients with thrombosed mechanical valves [1, 2, 3]. In TROIA Trial, low dose (25 mg)—slow infusion (6 h) of tissue type plasminogen activator (t-PA) has been found to be an effective and safe regimen in the management of prosthetic valve thrombosis (PVT) [4]. Accelerated and high dose TT regimens were associated with higher complication and mortality rates. 2014 AHA/ACC guideline for the management of patients with valvular heart disease had recommended emergency surgery for patients with left-sided PVT with NYHA Class III-IV (Class 1-B) and large, mobile thrombus(> 0.8 cm2) (Class 2a).
