[Thrombolysis of thrombosed heart valve prostheses: presentation of 2 cases and review of the literature].

Two women aged 38 and 51 years with thrombosed prosthetic heart valves (TPHV) in both tricuspid and mitral positions have been successfully treated with recombinant tissue plasminogen activator (rt-PA), 70 mg over 5 hours, and streptokinase (SK) 2,000,000 U over 10 hours without important complications. Cardiac surgery is the most commonly used therapy for combating this serious complication with a high mortality rate in general. There is controversy over the use of thrombolytics in TPHV. We reviewed the literature concerning treatment in 90 patients with this complication involving the different valve positions. We found an 80% therapeutical success rate, 8% partially successful, and 7% mortality rate. The main complications were of an embolic nature in 17% of cases, although the majority of these were transitory; haemorrhage occurred in 11% but there was only one case needing a transfusion. We conclude that thrombolytics are an efficient therapy in cases of TPHV in any position and should be started as soon as possible after the diagnosis has been confirmed.