European Journal of Case Reports in Internal Medicine (Apr 2023)

Successful thrombolytic therapy using ultraslow low-dose infusion during pregnancy for mitral mechanical valve thrombosis: a case series and review of the literature

  • Leila Bigdelu,
  • Ossama Maadarani,
  • Asal Yadolh,
  • Zouheir Bitar,
  • Nadia Azadi

DOI
https://doi.org/10.12890/2023_003856

Abstract

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According to the modified World Health Organization (WHO) classification, pregnant women with mechanical valves face a very high risk of complications (Risk Category III). Mechanical valve thrombosis is a serious complication that significantly increases during pregnancy due to multiple mechanisms. Thrombolytic therapy has recently been used as a first-line treatment for mechanical valve thrombosis during pregnancy. However, the consensus regarding the optimal treatment strategy, type, dose and route of administration was unclear. We present three cases of mechanical mitral valve thrombosis during pregnancy treated successfully with repeated doses of ultraslow infusion of low-dose tissue-type plasminogen activator (t-PA) alteplase. We also present a review of the literature on this subject.

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