Successful thrombolysis of st. Jude medical aortic prosthesis with tissue-type plasminogen activator in a pregnant XXXX : a case report.

@entity1 @entity715 @entity1229 @entity908
Mechanical valve @entity715 is a life-threatening event. Pregnancy is associated with a hypercoagulable state that further emphasizes the importance of adequate anticoagulation. This is associated with a therapeutic dilemma. Continued anticoagulation with @entity1229 throughout the first trimester can result in fetopathic effects, while replacement of @entity1229 by heparin between 6 and 12 weeks of gestation does not completely prevent the risk of valve @entity715 . There are a small number of reported cases of pregnant @entity1 with prosthetic heart valve @entity715 under low molecular weight heparin and consecutive lytic therapy. The authors report a 33-year-old pregnant @entity1 with a St. Jude Medical aortic prosthesis, anticoagulated with a therapeutic dosage of low molecular weight heparin from 6 weeks of gestation, who developed prosthetic heart valve @entity715 at 17 weeks of gestation. A thrombolysis with recombinant tissue-type plasminogen activator (50 mg for 2 hours) was performed. Under thrombolysis, ST-segment elevation in leads II, III, aVF, V5, and V6 developed electrocardiographically with a maximal @entity908 kinase (CK) of 349 U/L (CK-MB isoenzyme of 48 U/L). Echocardiography revealed normal function of the St. Jude Medical aortic prosthesis 2 hours after thrombolysis and normal wall motions. Short-course thrombolytic therapy appears to be an effective alternative to surgical intervention for the treatment of @entity715 of valve prostheses in pregnancy.
