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Year : 2016  |  Volume : 2  |  Issue : 1  |  Page : 7-12

Prosthetic heart valve thrombosis: Diagnosis and newer thrombolytic regimes

Department of Cardiology, All Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Shanmugam Krishnan
Senior Resident, Department of Cardiology, All India Institute of Medical Sciences, New Delhi - 110 029
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2395-5414.182993

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Prosthetic heart valve thrombosis incidence is high in developing countries and contributes to significant late mortality postvalve surgery. Many guidelines advocate surgery as the first line therapy though thrombolysis is often used in many centers. In this article, we review the newer regimens of fibrin-specific thrombolytics. Newer regimens of very low-dose, slow infusion lead to equal efficacy with lower complication in majority of patients. Patients with the New York Heart Association (NYHA) Class I–II who have low thrombus burden should receive thrombolysis with low-dose slow infusion while those with high thrombus burden should be planned for surgery. Patients presenting with NYHA Class IV should be treated with classical dose thrombolysis.

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