PMID- 20460341
OWN - NLM
STAT- MEDLINE
DCOM- 20110902
LR  - 20110509
IS  - 1938-2723 (Electronic)
IS  - 1076-0296 (Linking)
VI  - 17
IP  - 3
DP  - 2011 Jun
TI  - Acute myocardial infarction during thrombolysis of mechanical aortic valve 
      thrombosis associated with heparin-induced thrombocytopenia.
PG  - 283-7
LID - 10.1177/1076029610363130 [doi]
AB  - We report a case of a 60-year-old man with obstructive aortic prosthetic valve 
      thrombosis (APVT). He was treated with low-dose (25 mg) slow infusion (6 hours) 
      of intravenous tissue plasminogen activator (t-PA), and he suffered acute 
      anterior myocardial infarction (MI) at the fourth hour of t-PA infusion. Infusion 
      was kept on, and coronary reperfusion and successful lysis of APVT were achieved. 
      Intravenous unfractionated heparin (UFH) was then started, however, on the third 
      day following heparin treatment, heparin-induced thrombocytopenia (HIT) was 
      recognized by a drop in the platelet count and rethrombosis of the prosthetic 
      valve. Although no nonheparin anticoagulant was available, intravenous continuous 
      infusion of streptokinase (SKZ) 250,000 U per day was administered for 5 days 
      followed by transition to warfarin therapy. Successful lysis of the APVT was 
      again achieved with this regimen and the patient was discharged after uneventful 
      recovery. The patient remained well at 6 months and 1 year follow-up.
FAU - Gunduz, Sabahattin
AU  - Gunduz S
AD  - Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, 
      Istanbul, Turkey.
FAU - Ozkan, Mehmet
AU  - Ozkan M
FAU - Biteker, Murat
AU  - Biteker M
FAU - Duran, Nilufer Eksi
AU  - Duran NE
FAU - Guneysu, Tahsin
AU  - Guneysu T
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20100511
PL  - United States
TA  - Clin Appl Thromb Hemost
JT  - Clinical and applied thrombosis/hemostasis : official journal of the 
      International Academy of Clinical and Applied Thrombosis/Hemostasis
JID - 9508125
RN  - 0 (Fibrinolytic Agents)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
SB  - IM
MH  - Aortic Valve
MH  - Fibrinolytic Agents/administration & dosage/*adverse effects
MH  - Heart Valve Prosthesis
MH  - Heparin/administration & dosage/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Myocardial Infarction/etiology/therapy
MH  - Thrombocytopenia/*chemically induced/*drug therapy
MH  - Thrombolytic Therapy/*adverse effects
MH  - Thrombosis/*drug therapy
MH  - Tissue Plasminogen Activator/administration & dosage
EDAT- 2010/05/13 06:00
MHDA- 2011/09/03 06:00
CRDT- 2010/05/13 06:00
PHST- 2010/05/13 06:00 [entrez]
PHST- 2010/05/13 06:00 [pubmed]
PHST- 2011/09/03 06:00 [medline]
AID - 1076029610363130 [pii]
AID - 10.1177/1076029610363130 [doi]
PST - ppublish
SO  - Clin Appl Thromb Hemost. 2011 Jun;17(3):283-7. doi: 10.1177/1076029610363130. 
      Epub 2010 May 11.