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Background: The optimal strategy in prosthetic heart valve thrombosis (PVT) remains controversial, with no randomized trials and conflicting observational data. We performed a systematic review and meta-analysis of evidence comparing systemic thrombolysis and cardiac surgery in PVT.
Methods And Results: We searched PubMed, the Cochrane Library, and Embase for studies on treatment strategies in patients with left-sided PVT since 2000.
Successful treatment of acute device thrombosis of patent foramen ovale with slow infusion of low-dose thrombolytic therapy.
Eur Heart J Case Rep
August 2024
Kartal Kosuyolu High Specialty Training and Research Hospital, Department of Cardiology, University of Medical Sciences, Istanbul, Turkey.
Article Synopsis
- Percutaneous closure of patent foramen ovale (PFO) helps prevent recurrent cerebral embolism, but device-related thrombosis can occur, leading to serious complications.
- A case is presented of a 40-year-old woman who developed a thrombus after PFO closure, which was successfully treated with a slow infusion of low-dose tissue plasminogen activator (t-PA).
- This case highlights that while acute thrombosis of PFO devices is rare, low-dose t-PA can be an effective treatment option if there are no contraindications.
Surgery compared to fibrinolytic therapy for symptomatic left-sided prosthetic heart valve thrombosis (SAFE-PVT): Rationale and design of a randomized controlled trial.
Indian Heart J
July 2024
Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi, India; Translational Health Science and Technology Institute, Faridabad, Haryana, India. Electronic address:
Background: Left-sided mechanical prosthetic heart valve thrombosis (PVT) occurs because of suboptimal anticoagulation and is common in low-resource settings. Urgent surgery and fibrinolytic therapy (FT) are the two treatment options available for this condition. Urgent surgery is a high-risk procedure but results in successful restoration of valve function more often and is the treatment of choice in developed countries.
View Article and Find Full Text PDF[Sodium glucose cotransporter-2 inhibitors (SGLT2i) and risk of ketoacidosis].
Lakartidningen
February 2024
med dr, specialist i klinisk kemi och klinisk farmakologi, chef för Läkemedelscentrum, chef för Läkemedelscentrum; samtliga Norrlands universitetssjukhus, Umeå.
SGLT2i can induce euglycemic diabetic ketoacidosis (eDKA) in conditions with relative insulin deficiency, such as infections, surgery, or fasting state. In comparison with classical DKA, eDKA typically presents with lower blood glucose levels and more diffuse symptoms like tiredness, tachypnea, nausea and abdominal pain. The diagnosis is commonly delayed, and signs are often attributed to other factors.
View Article and Find Full Text PDFA low-dose thrombolytic infusion protocol for safe and successful treatment of left ventricular assist device thrombosis: a case series.
Eur Heart J Case Rep
January 2024
Division of Cardiology, Department of Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, USA.
Article Synopsis
- A study evaluated a new treatment method using low-dose, slow infusion of tissue plasminogen activator (alteplase) for pump thrombosis in patients with continuous-flow left ventricular assist devices (CF-LVAD).
- The protocol was applied to four female patients over four years, resulting in successful treatment of six out of seven thrombosis cases, although one patient faced severe complications and died.
- The findings suggest that this approach is effective and has a lower risk of bleeding complications compared to traditional methods.
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