Document Detail


Acute myocardial infarction during thrombolysis of mechanical aortic valve thrombosis associated with heparin-induced thrombocytopenia.
MedLine Citation:
PMID:  20460341     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
We report a case of a 60-year-old man with obstructive aortic prosthetic valve thrombosis (APVT). He was treated with low-dose (25 mg) slow infusion (6 hours) of intravenous tissue plasminogen activator (t-PA), and he suffered acute anterior myocardial infarction (MI) at the fourth hour of t-PA infusion. Infusion was kept on, and coronary reperfusion and successful lysis of APVT were achieved. Intravenous unfractionated heparin (UFH) was then started, however, on the third day following heparin treatment, heparin-induced thrombocytopenia (HIT) was recognized by a drop in the platelet count and rethrombosis of the prosthetic valve. Although no nonheparin anticoagulant was available, intravenous continuous infusion of streptokinase (SKZ) 250 000 U per day was administered for 5 days followed by transition to warfarin therapy. Successful lysis of the APVT was again achieved with this regimen and the patient was discharged after uneventful recovery. The patient remained well at 6 months and 1 year follow-up.
Authors:
Sabahattin Gündüz; Mehmet Ozkan; Murat Biteker; Nilüfer Eksi Duran; Tahsin Güneysu
Publication Detail:
Type:  Journal Article     Date:  2010-05-11
Journal Detail:
Title:  Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis     Volume:  17     ISSN:  1938-2723     ISO Abbreviation:  Clin. Appl. Thromb. Hemost.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508125     Medline TA:  Clin Appl Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  283-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
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