Thrombolytic therapy for prosthetic valve thrombosis in children: two case reports and review of the literature

Abstract

Thrombotic occlusion of a mechanical valve prosthesis can be life threatening and requires urgent evaluation and treatment. Traditionally, the treatment for mechanical valve thrombosis has been urgent reoperation with attempted declotting of the valve or valve rereplacement. Unfortunately, this is associated with a high mortality, and efforts have been made to pursue nonoperative treatment with thrombolytics. There are many reports of the successful use of thrombolytics in adults, but very little data are reported in the pediatric population. We review the literature, report 2 cases of successful treatment of mechanical mitral valve thrombotic occlusion with thrombolytic therapy in children, and summarize the major reports of thrombolytic use for prosthetic valve occlusion in the pediatric population.