Author + information
- Maryam Taherkhani1,
- Reza Hashemi Hashemi1,
- Manouchehr Hekmat2,
- Morteza Safi1,
- Adineh Taherkhani1 and
- Mohammad Reza Movahed3
Treatment data using thrombolytic in the setting of right sided mechanical valve thrombosis are almost nonexistent and all the guidelines are based on a very small case series. The goal of this manuscript was to perform survival analysis of larges case series of patients with right sided mechanical valve thrombosis treated with thrombolytic therapy.
We reviewed in-hospital and long term outcome data for survival analysis of patients presenting with right sided mechanical pulmonic and tricuspid valve thrombosis treated with thrombolytic therapy from September 2005 until Jun 2012 retrospectively.
A total of 16 patients with definite thrombotic mechanical valve obstruction in tricuspid or pulmonary position were identified (8 in pulmonary and 8 tricuspid position) who underwent thrombolytic therapy. All the patients except one had sup-therapeutic INR. All 8 pulmonic mechanical valve thrombosis were in children with 100% respond rate to thrombolytic therapy. In hospital survival rate of pulmonic valve thrombosis treated with thrombolytic therapy was 100%. One year survival rate of successful treated mechanical valve pulmonic valve thrombosis was 87.5%.
Based on our data, we strongly recommend that thrombolytic therapy should remain the first line therapy for the right sided mechanical valve thrombosis in adults or children including children with complex congenital heart disease and patients with mechanical pulmonic valve thrombosis. Surgery should be reserved for patients who fail this treatment.