[Thrombolytic therapy of thrombosed Björk-Shiley aortic valve prosthesis--report of four cases]

[Thrombolytic therapy of thrombosed Björk-Shiley aortic valve prosthesis--report of four cases] Research Abstract Details 

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[Thrombolytic therapy of thrombosed Björk-Shiley aortic valve prosthesis--report of four cases] Abstract Text:

T Asakura,T Jikuya,N Atsumi,Y Terada,Y Sakakibara,T Mitsui,

Prosthetic valve thrombosis is associated with high mortality. Thrombolytic therapy is a promising alternative to valve replacement in the management of prosthetic valve thrombosis. To determine the efficacy and safety of thrombolytic therapy for thrombosed Björk-Shiley aortic valve prosthesis, 4 patients who received urokinase intravenously for this disorder were analyzed. In 3 patients, the successful outcome was sustained in that they remained asymptomatic and did not require operative intervention during follow-up, which ranged from 17 to 101 months. In one patient clinical signs of mild congestive heart failure occurred. This patient was surgically treated by thrombectomy and debridement of the prosthetic valve. Failure of urokinase treatment to resolve the thrombus after 1 week indicates that tissue overgrowth or fibrous, organized thrombus is the cause of prosthetic malfunction. Surgical intervention for this problem should be considered only after thrombolytic therapy has been tried and has failed. Our experience with urokinase treatment of thrombosis of aortic Björk-shiley prostheses indicates that this form of treatment should always be applied before surgical intervention. We also attempted to define the optimum protocol of fibrinolytic therapy by clinical evaluation. A protocol for the safe treatment of thrombosed valve is urokinase in initially administered in the doses as 960,000 units for 24 hours, then followed by a maintenance infusion at the half dose every 24 or 48 hours later. Thrombolytic therapy should be continued for 1 week at least to prevent rethrombosis even normalization of valve function was documented clinically. Simultaneous heparin infusion of 10,000 units for 24 hours is then started to replaced by warfarin treatment adjusted to obtain optimal prothrombin times.(ABSTRACT TRUNCATED AT 250 WORDS)

[Thrombolytic therapy of thrombosed Björk-Shiley aortic valve prosthesis--report of four cases] Publishing Authors By Initials

T Asakura,T Jikuya,N Atsumi,Y Terada,Y Sakakibara,T Mitsui,

For similar enzymes and coenzymes: enzymes: hydrolases: peptide hydrolases: endopeptidases: serine endopeptidases: urinary plasminogen activator research abstracts see: enzymes and coenzymes: enzymes: hydrolases: peptide hydrolases: endopeptidases: serine endopeptidases: urinary plasminogen activator research

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[Thrombolytic therapy of thrombosed Björk-Shiley aortic valve prosthesis--report of four cases] Journal Published:

PUBLICATION TYPE: Journal Article

Journal: [Zasshi] [Journal]. Nihon Ky?bu Geka Gakkai

VOLUME: 42

Page Numbers: 1214-21

Journal Abbreviation:

ISSN: 0369-4739

DAY: 14

MONTH: Aug

YEAR: 1994

[Thrombolytic therapy of thrombosed Björk-Shiley aortic valve prosthesis--report of four cases] Information

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LANGUAGE: jpn

NlmUniqueID: 19130180

[Thrombolytic therapy of thrombosed Björk-Shiley aortic valve prosthesis--report of four cases] Keywords Mesh Terms:

KEYWORDS: Urinary Plasminogen Activator

MESH TERMS: therapeutic use

Chemical & Substance for Abstract: [Thrombolytic therapy of thrombosed Björk-Shiley aortic valve prosthesis--report of four cases] Information

Substance Name: Urinary Plasminogen Activator

Registry Number: EC 3.4.21.73

Grant and Affiliation Information for [Thrombolytic therapy of thrombosed Björk-Shiley aortic valve prosthesis--report of four cases]

AFFILIATION: Department of Cardiovascular Surgery, University of Tsukuba Hospital, Japan.

Country: JAPAN

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MEDLINETA: Nippon Kyobu Geka Gakkai Zassh

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