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Successful Thrombolytic Treatment of a Thrombosed Mechanical Mitral Valve in a Post-brain Surgery Patient- A Case Report and Literature Review

Mostafa Q Al-Shamiri

The first-line management of prosthetic valve thrombosis is not yet finalized; dealing with such cases remains a clinical challenge and requires prompt detection, timely diagnosis and individualized case management regardless of whether the case in question requires a surgical or medical therapeutic approach. We report a unique case of mechanical mitral valve thrombosis post Bentall procedure with a double aortic-mitral valve replacement in a patient who previously underwent brain surgery after experiencing a Road Traffic Accident (RTA). The patient was successfully treated by using a combined loading and infusion regimen of tissue-Plasminogen Activators (t-PA). A small loading dose of 15 mg followed by a low-dose slow infusion of t-PA has been shown to provide effective and safe thrombolysis in high-risk patients with prosthetic valve thrombosis.