Title: Successful thrombolysis by low dose slow intravenous alteplase infusion in critically ill patients with stuck prosthetic mitral valve:a case study

Abstract:

Prosthetic valve thrombosis(PVT) contributes to significant post valve replacement mortality and morbidity.Treatment guidelines are controversial,ranging from surgical intervention to thrombolysis.We report a case study of two challenging patients who presented in our hospital,known Rheumatic Heart Disease,Post Mitral Valve Replacement,with Acute Left ventricular failure in NYHA class IV and PVT,of which one had coagulopathy with grossly deranged INR.Both patients were put on intermittent non invasive ventilator and inotropic supports,and successfully thrombolysed with low dose slow intravenous Alteplase infusion given every 6 hours in discrete doses with monitoring of PT/INR and mitral valve gradients,resulting in remarkable clinical improvement .Their successful treatment shows that thrombolysis can be considered as an effective treatment modality in high risk surgery patients with stuck prosthetic mitral valve.

Biography:

Aparajita Kumar has completed Diploma Cardiology in 2015 from MS Ramaiah Narayana Hrudalaya, Bangalore,,and is an International Associate, American College of Cardiology.She has over 7 years experience in Cardiology having previouly worked in leading corporate hospitals,,and is presently working as Consultant Cardiology-Non interventional in Max Hospital Dehradun, India.She has attended  several national and international conferences,and has been a presenter in International Trauma Conference.She had been awarded Second prize in National Young Genie Champion in Cardiology in 2016.She has a keen interest in research,and completed Research to Publication course by UCMS California and BMJ for designing clinical trials and scientific writing,and was awarded 200 CPD credits for the same.Her key interests are Preventive cardiology, echocardiography and hypertension.