Fibrinolytic treatment of XXXX on prosthetic heart valves.

@entity1 @entity583 @entity4 @entity409 @entity3885 @entity715 @entity3257
Fibrinolytic agents were administered for 13 episodes of @entity715 formation on mitral or aortic valvar prostheses in 12 @entity1 . The most common presenting features were @entity4 (six cases) or arterial emboli (six cases). The diagnosis of @entity715 formation was made by phonocardiography on the following criteria: (a) modifications of the prosthetic sounds (12 cases), (b) appearance of a @entity3885 (10 cases). The treatment consisted of streptokinase (100 000 units/h after a loading dose, seven cases) or urokinase using either low doses (75 000 or 112 500 units/h, three cases) or moderate doses (150 000 units/h, three cases) for one to four days. Immediate complete regression of clinical and phonocardiographic anomalies was seen in eight cases. Incomplete improvement was seen in two @entity1 , leading to operation: this was unsuccessful in one @entity1 who had surgery on the third day, and was successful in the other on the 75th day. There were three failures leading to successful reoperative procedures in two @entity1 and to an early death in the third @entity1 suffering from @entity583 . One @entity3257 was observed in a @entity1 treated with streptokinase. No important side effect was noted during delivery in a pregnant @entity1 . During subsequent follow-up, a recurrent episode of @entity715 formation was observed in one @entity1 , treated by fibrinolytic therapy with success. One @entity1 had an operation for a valve replacement six months after fibrinolytic treatment because of non-thrombotic @entity409 ; the outcome was fatal. Six @entity1 are alive and in good condition, with a follow-up of six months to five years.
