Thrombus attached to suture materials successfully thrombolysed with low-dose tissue plasminogen activator

Mechanical prosthetic heart valve thrombosis is one of the most common complications of valve surgery. We herein describe an unusual clinical vignette. A 60-yearold man who underwent prosthetic mitral valve reoperation suffered from nonobstructive thrombus attached to the elongated suture materials in the postoperative sixth month. The thrombus was precisely depicted by two- and three-dimensional transesophageal echocardiography and was successfully lysed with low-dose slow infusion of tissue plasminogen activator after failed heparin treatment.