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Correspondence
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Volume 333:259 July 27, 1995 Number 4
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Recombinant Tissue Plasminogen Activator for Prosthetic Mitral-Valve Thrombosis

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To the Editor: The reported incidence of thrombosis of prosthetic mitral or aortic valves ranges from 0.03 to 4.3 percent per year.1 Thrombectomy or valve replacement is the conventional treatment for this condition, with an associated mortality rate ranging from 4.7 to 20 percent.2 Thrombolysis is emerging as a promising alternative to surgery, particularly in critically ill patients, with a success rate ranging from 75 to 83 percent.1 Most patients in published series have been treated with infusions of streptokinase or urokinase for 12 to 24 hours.1,3,4 Not all obstructed valves respond to thrombolysis, however. The valve obstruction is due . . . [Full Text of this Article]

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