Successful thrombolytic treatment of a bio-prosthetic mitral valve thrombosis in a pregnant woman

摘要

Even though it is a rare complication, the pro-coagulant condition of pregnancy may predispose to thrombosis of a bio-prosthetic mitral valve (BPMV). We report the successful reduced-dose, slow infusion of tissue plasminogen activator (t-PA) to a BPMV thrombosis in a pregnant woman. When the patient was seen in the emergency clinic she was dyspnoeic and tachycardic and evaluated as NYHA class III-IV. On transthoracic echocardiography (TTE) the BPMV leaflet movement was restricted and a high transmitral valve gradient was measured. Transoesophageal echocardiography showed thrombosis of the BPMV. After slow infusion of t-PA with heparin, on TTE the gradient was decreased with free movement of the BPMV leaflet and with fast clinical improvement.