Prosthetic valve thrombosis (PVT) is a rare but serious complication of implanted mechanical valves. Intravenous thrombolytic treatment has emerged as an alternative to surgical therapy in the management of patients with stuck valves. As tricuspid valve replacement is a rare venture, the indications for such therapy and appropriate patient selection are evolving. As the type, dose, and route of administration of thrombolytic agents differ, major complications can be seen in the rapid infusion protocols. In patients with PVT, especially with right-sided valves, thrombolysis with intravenous slow infusion has given discrete, successive sessions guided by serial transthoracic echocardiography and cine/fluoroscopy which may be achieved with a low risk of complications and a high rate of success. Our report describes the management of two patients with PVT and discusses the current status of thrombolysis in such patients.
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http://dx.doi.org/10.1097/MBC.0000000000000215 | DOI Listing |
Catheter Cardiovasc Interv
January 2025
Cardiology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Transcatheter aortic valve replacement (TAVR) is a well-established treatment for severe aortic stenosis, especially in patients over 75 or those at high surgical risk. While these prosthetic valves have a lower thrombogenic profile than mechanical heart valves, leaflet thrombosis in transcatheter aortic valves (TAV) occurs in an estimated 5%-40% of cases. Most TAV thromboses are subclinical and can be detected via cardiac computed tomography (CCT), which reveals hypo-attenuating leaflet thickening and reduced leaflet motion in asymptomatic patients without elevated transprosthetic gradients on echocardiography.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Radiodiagnosis and Interventional Radiology, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India.
Budd-Chiari syndrome with obstruction in the inferior vena cava causes increased venous pressure in the azygous-hemiazygous system and paravertebral venous plexus, which is transmitted to the epidural venous plexus, devoid of the valves. It causes epidural venous plexus engorgement and venous congestion and may present rarely with low back pain or radiating pain. However, patients developing lower limb weakness as a complication of Budd-Chiari syndrome is an infrequent and severe presentation.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Cardiovascular Medicine, Sendai Kousei Hospital, 1-20 Tsutsumidori-amamiya, Aoba Ward, Sendai, Miyagi 9810914, Japan.
Background: Transcatheter edge-to-edge mitral valve repair (M-TEER) using the MitraClip system is primarily performed using the transfemoral approach. However, when this approach is not feasible, the transjugular approach can be used as an alternative.
Case Summary: A 57-year-old man presented with heart failure and persistent New York Heart Association class IV symptoms, refractory to guideline-directed medical therapy, intravenous therapy, and intra-aortic balloon pumping.
Cardiovasc Pathol
December 2024
University Hospital Muenster, Department of Cardiothoracic Surgery, Muenster, Germany.
Objectives: Re-operations due to material degeneration carry a burden for patients with congenital heart disease (CHD). The study aim was to compare rapid vs. slow degeneration of biomaterials in CHD patients.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan.
Background: Transcatheter aortic valve replacement (TAVR) is a well-established treatment option for patients with severe aortic valve stenosis; however, clinical valve thrombosis is a major challenge.
Case Summary: A 92-year-old woman underwent TAVR for severe aortic stenosis. One month later, the patient developed acute heart failure.
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