Abbas Shahid, Hameed Naeem, Khilji Shahbaz Ahmed, Jalal Anjum
Shahid Abbas, FCPS (Cardiology). Associate Professor of Cardiology, Faisalabad Institute of Cardiology, Faisalabad, Pakistan.
Naeem Hameed, FCPS (Cardiology). Senior Registrar Cardiology Faisalabad Institute of Cardiology, Faisalabad, Pakistan.
Pak J Med Sci. 2021 Mar-Apr;37(2):325-330. doi: 10.12669/pjms.37.2.3226.
To evaluate the outcome of thrombolysis in patients of prosthetic valve thrombosis.
This retrospective analysis was conducted on data of 84 patients of prosthetic valve thrombosis who presented to emergency room of Faisalabad Institute of Cardiology between July 2017 to December 2019. The diagnosis of prosthetic valve thrombosis was based on clinical suspicion and bed side transthoracic echocardiography done by a consultant cardiologist. Fluoroscopy was done to confirm the diagnosis by observing immobile valve leaflet. The confirmed patients were then treated in emergency with streptokinase after taking an informed consent. Quantitative variables like age were summarized by mean and standard deviation. Qualitative variables like gender, successful thrombolysis, stroke, major bleeding, mortality or re-do surgery were summarized by frequency and percentage.
Mean age was 29 ± 6.36, years and there were more female patients (n=43, 51.25%) as compared to males (n=41, 48.8%). Among the 66 surviving patients thrombolysis was successful without any complications in 56 patients (66.7%). Thrombolysis was successful with minor complications in six patients (7.1%) and it failed to produce desired results in four patients (4.8%). In this study 18 (21.4%) patients died. The common complications included minor bleeding in four patients (4.8%) and major bleeding in 10 patients (12.0 %).
Thrombolysis produces reasonable success rate in cases of prosthetic valve thrombosis who are in functional class I or II. However, it has very high mortality rate in patients presenting with functional class III and IV.
评估人工瓣膜血栓形成患者的溶栓治疗效果。
对2017年7月至2019年12月在费萨拉巴德心脏病学研究所急诊室就诊的84例人工瓣膜血栓形成患者的数据进行回顾性分析。人工瓣膜血栓形成的诊断基于临床怀疑以及由心脏科顾问医生进行的床边经胸超声心动图检查。通过观察瓣膜叶活动度进行荧光透视以确诊。确诊患者在获得知情同意后在急诊室接受链激酶治疗。年龄等定量变量以均值和标准差进行总结。性别、溶栓成功、中风、大出血、死亡率或再次手术等定性变量以频率和百分比进行总结。
平均年龄为29±6.36岁，女性患者（n = 43，51.25%）多于男性患者（n = 41，48.8%）。在66例存活患者中，56例（66.7%）溶栓成功且无任何并发症。6例患者（7.1%）溶栓成功但有轻微并发症，4例患者（4.8%）溶栓未取得预期效果。本研究中有18例（21.4%）患者死亡。常见并发症包括4例患者（4.8%）出现轻微出血和10例患者（12.0%）出现大出血。
溶栓治疗在功能分级为I级或II级的人工瓣膜血栓形成病例中成功率合理。然而，在功能分级为III级和IV级的患者中死亡率非常高。
