Fibrinolytic Therapy of Prosthetic Mitral Valve Thrombosis During Pregnancy: Three Case Reports and Review of the Literature

Abstract

The incidence of prosthetic valve thrombosis (PVT), which is a life-threatening complication, increased during pregnancy because of the hypercoagulable state. Despite adequate anticoagulation, the incidence of PVT has been estimated as 4% to 14% during pregnancy. Prosthetic valve thrombosis occurring during pregnancy requires urgent therapy including fibrinolytic therapy, valve replacement, and surgical thrombectomy due to high mortality. Although surgery has traditionally been the standard procedure for treatment of PVT, fibrinolytic therapy may be used as first-line therapy according to data from the recent reports. Data about the fibrinolytic therapy is scarce and controversial in the setting of pregnancies complicated with PVT. Herein, we share the outcomes of 3 pregnant women complicated with PVT and treated with recombinant tissue-type plasminogen activator.