Thrombolytic Therapy of Prosthetic Tricuspid Valve Thrombosis in a Pregnant Woman

A 21-year-od woman who was pregnant for 4 months and had thrombosed single-disk tricuspid valve was treated with rtPA with a total dose of 100 mg infused over two hours in November 1993 in our department. Upon completion of the infusion clinical symptoms improved, and the tricuspid valve gradient diminished to a mean of 2 mmHg from 7-12 mmHg. The patient, discharged 14 days later asymptomatically, delivered on the 85th day of therapy a premature infant of 6-month gestational age with sectio who died 24 hours later. Necropsy confirmed ablatio placenta and prematurity without evidence suggesting an effect of fibrinolytic therapy. Thrombolytic therapy may materialise favorable results (as an alternative to surgery) in patients with thrombosed tricuspid prostethic valve.