Páez-Zamora Laura Juliana, Durán Angélica Rojas
Los Cobos Medical Center, Universidad El Bosque, Bogotá, Colombia.
Los Cobos Medical Center, Universidad El Bosque, Bogotá, Colombia.
JACC Case Rep. 2025 Aug 20;30(24):104678. doi: 10.1016/j.jaccas.2025.104678.
Bioprosthetic valve thrombosis (BPVT) is rare, with an incidence of 0.2% to 6.0%. It often presents as heart failure, thromboembolism, or a new murmur. Diagnosis relies on transthoracic and transesophageal echocardiography, with treatment traditionally being surgical.
We report a 74-year-old patient with valvular and Chagas-related heart disease who developed BPVT of the aortic valve. Owing to high surgical risk and lack of response to heparin, ultraslow low-dose thrombolysis was performed, achieving a successful outcome.
The emerging therapies for BPVT have a lower risk of mortality when compared with surgical management. Although to our knowledge there are no studies regarding the use of ultraslow low-dose thrombolysis on patients with aortic BPVT, this case demonstrates the safety and efficacy of this approach.
生物瓣血栓形成（BPVT）较为罕见，发病率为0.2%至6.0%。其常表现为心力衰竭、血栓栓塞或新出现的杂音。诊断依赖于经胸和经食管超声心动图，传统治疗方法为手术治疗。
我们报告一例74岁患有瓣膜性和恰加斯病相关心脏病的患者，其发生了主动脉瓣BPVT。由于手术风险高且对肝素无反应，遂进行了超慢速低剂量溶栓治疗，并取得了成功。
与手术治疗相比，BPVT的新兴治疗方法死亡率较低。尽管据我们所知，尚无关于对主动脉BPVT患者使用超慢速低剂量溶栓治疗的研究，但本病例证明了该方法的安全性和有效性。
