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You are here: Contents > 2017 > Volume 26 Number 3 May 2017 > THROMBOSIS, EMBOLISM AND BLEEDING > Treatment of Prosthetic Valve Thrombosis with Bolus Dose Tenecteplase: An Experience from a Developing Country

Treatment of Prosthetic Valve Thrombosis with Bolus Dose Tenecteplase: An Experience from a Developing Country

Rajesh Kumar Jha1,2, Sandeep Bansal1, H. S. Issar1, Mayuresh Chaudhary1, Sonu Sharma1

1Department of Cardiovascular Medicine, First Affiliated Hospital, Harbin Medical University, Harbin, China
2Academician Workstation, Harbin Medical University, and Heilongjiang Academy of Medical Sciences, Harbin, China
3Eye Hospital, First Affiliated Hospital, Harbin Medical University, Harbin, China
4Electronic correspondence: liqian0041@139.com

Background and aim of the study: Prosthetic valve thrombosis (PVT) in metallic prosthetic cardiac valves is not an uncommon condition, and has high mortality and morbidity. Although surgery is the traditional choice for PVT therapy, thrombolysis with newer agents has achieved good success rates. Many studies described in the western literature have used tissue plasminogen activators, while studies from developing countries have been largely based on the use of streptokinase and urokinase. Data regarding the use of newer agents such as tenecteplase are scant. Hence, the study aim was to evaluate the safety and efficacy of tenecteplase in left-sided PVT.

 


Methods and Results: Between 2013 and 2016, a total of 18 patients with PVT was treated with a 40 mg bolus dose of tenecteplase. Significantly, one patient was a pregnant lady in whom a lower dose (25 mg) was successfully and safely used. Thrombolysis was followed by enoxaparin and oral anticoagulation in patients, all of whom had complete lysis of thrombus and clinical improvement.

Conclusion: Tenecteplase is an effective and excellent therapeutic agent for PVT, with a good safety margin. Its safe use in pregnancy points to a possible optional therapy, but this requires confirmation.

The Journal of Heart Valve Disease 2017;26:349-354


Treatment of Prosthetic Valve Thrombosis with Bolus Dose Tenecteplase: An Experience from a Developing Country

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