[Thrombolytic therapy in a case of mitral valve thrombosis (author's transl)].

In this paper we present a case in which thrombolytic treatment with Streptokinase was successful in a 53-year-old patient, who developed valve thrombosis one year after aortic and mitral-valve replacement by Björk-Shiley tilding-disk-valve prosthesis. The patient suffered from pulmonary congestion and cardiogenic shock. In spite of Arterenol infusion the blood pressure fell down to 90/50 mm Hg. The systolic pulmonary artery-pressure rose up to 120 mm Hg, the cardiac output was 1.8 l/min. The patient became anuric. A transport to the next department of cardiovascular surgery was impossible. In this extraordinary critical situation for the patient we introduced a thrombolytic therapy with Streptokinase. Within a few hours, the systolic pulmonary artery-pressure fell down by 33%, the cardiac output increased by 100%. One and half days later the patient did not need Arterenol infusion and the blood pressure was 120/80 mm Hg. Referring to this observation, we conclude that Streptokinase therapy can be a successful emergency-treatment of a life-threatening artificial heart-valve thrombosis, if surgical treatment is impossible.