Complete thrombus resolution with tirofiban in obstructive mechanical prosthetic mitral valve thrombosis

Abstract

Mechanical prosthetic valve thrombosis is a rare but life threatening complication after valve replacement. Although the traditional treatment of prosthetic valve thrombosis is surgery, recently thrombolytic therapy has been accepted as an alternative treatment. We describe for the first time prosthetic valve obstructive thrombus that was resolved by administering tirofiban (glycoprotein IIb/IIIa receptor antagonist) in a patient using warfarin with an international normalized ratio of 3.4. In our view, although this issue need to be clarified in further studies, tirofiban seems to be an alternative therapy especially in patients who have high risk of bleeding or surgical complication.