Thrombolysis of prosthetic tricuspid valve thrombosis with human recombinant tissue plasminogen activator in an adolescent

Prosthetic heart valve thrombosis is associated with a high mortality. Traditionally, thrombectomy or valve replacement is performed. Thrombolysis offers a promising alternative to surgery. Usually, streptokinase and urokinase are the preferred agents for thrombolysis; however, human recombinant tissue plasminogen activator (rt-PA) is increasingly used. Thrombosis of prosthetic valves in children and adolescents is rare and experience of thrombolysis for obstructed valves is limited. We report the successful lysis of a thrombosed prosthetic tricuspid valve in an adolescent using rt-PA. The outcome of our patient supports the assumption that rt-PA represents an adequate therapeutic option for thrombolysis of obstructed prosthetic heart valves in children and adolescents.