Outcome of thrombolysis with streptokinase in patients with prosthetic valve thrombosis

  • Shahid Abbas, Dr. Faisalabad Institute of Cardiology
  • Naeem Hameed, Dr. Faisalabad Institute of Cardiology
  • Shahbaz Ahmad Khilji, Dr. Faisalabad Institute of Cardiology
  • Anjum Jalal, Prof. Faisalabad Institute of Cardiology
Keywords: Prosthetic Valve Thrombosis, Rheumatic Heart Disease, Thrombolysis, Thromboembolism, Anticoagulation

Abstract

Objective: To evaluate the outcome of thrombolysis in patients of prosthetic valve thrombosis.

Methods: This retrospective analysis was conducted on data of 84 patients of prosthetic valve thrombosis who presented to emergency room of Faisalabad Institute of Cardiology between July 2017 to December 2019. The diagnosis of prosthetic valve thrombosis was based on clinical suspicion and bed side transthoracic echocardiography done by a consultant cardiologist. Fluoroscopy was done to confirm the diagnosis by observing immobile valve leaflet. The confirmed patients were then treated in emergency with streptokinase after taking an informed consent. Quantitative variables like age were summarized by mean and standard deviation. Qualitative variables like gender, successful thrombolysis, stroke, major bleeding, mortality or re-do surgery were summarized by frequency and percentage.

Results: Mean age was 29 ± 6.36, years and there were more female patients (n=43, 51.25%) as compared to males (n=41, 48.8%). Among the 66 surviving patients thrombolysis was successful without any complications in 56 patients (66.7%). Thrombolysis was successful with minor complications in six patients (7.1%) and it failed to produce desired results in four patients (4.8%). In this study 18 (21.4%) patients died. The common complications included minor bleeding in four patients (4.8%) and major bleeding in 10 patients (12.0 %).

Conclusion: Thrombolysis produces reasonable success rate in cases of prosthetic valve thrombosis who are in functional class I or II. However, it has very high mortality rate in patients presenting with functional class III and IV.

doi: https://doi.org/10.12669/pjms.37.2.3226

How to cite this:
Abbas S, Hameed N, Khilji SA, Jalal A. Outcome of thrombolysis with streptokinase in patients with prosthetic valve thrombosis. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3226

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Shahid Abbas, Dr., Faisalabad Institute of Cardiology

Associate Professor

Department of Cardiology

Naeem Hameed, Dr., Faisalabad Institute of Cardiology

Senior Registrar

Department of Cardiology

Shahbaz Ahmad Khilji, Dr., Faisalabad Institute of Cardiology

Associate Professor

Deparment of Cardiac Surgery

Anjum Jalal, Prof., Faisalabad Institute of Cardiology

Professor & Executive Director

Department of Cardiac Surgery

 

Published
2021-01-07
How to Cite
Abbas, S., Hameed, N., Khilji, S., & Jalal, A. (2021). Outcome of thrombolysis with streptokinase in patients with prosthetic valve thrombosis. Pakistan Journal of Medical Sciences, 37(2). https://doi.org/10.12669/pjms.37.2.3226
Section
Original Articles