Thrombolysis with Reteplase for recurrent mechanical heart valve thrombosis

Thrombotic occlusion of a prosthetic valve continues to be an uncommon but life threatening complication of mechanical valves. However, recurrent prosthetic valve thrombosis is yet a rare complication. Urokinase and tissue plasminogen activator (tPA) have previously been used with success in cases of recurrent thrombus formation and/or failure of streptokinase treatment. We report the first three cases of recurrent prosthetic mitral valve thrombosis in Pakistan which were treated with Reteplase that resulted in re-establishment of adequate blood flow across the valve with reduction of mean gradient to normal.