Successful Use of Two Thrombolytic Drugs in Prosthetic Mitral and Aortic Valve Thrombosis

Introduction: prosthetic valve thrombosis is a rare and severe complication of valve replacement, most often encountered with a mechanical prosthesis. the significant morbidity and mortality associated with this condition warrant rapid diagnostic evaluation. although surgery is the firstline therapy in symptomatic obstructive mechanical valve thrombosis, thrombolytic therapy has been used as an alternative. case description: in this case report, we describe a 46yearold man with a history of the mitral valve and aortic valve replacement 2 years ago. in echocardiography, we detected a mobile mass on the atrial side of the mitral valve prosthesis and a fixed one on the leaflet of the mechanical aortic valve with a high gradient. to save his life, we used double thrombolytic therapy considering the patient rsquo;s hemodynamic situation and the risk of bleeding. although a routine dose of reteplase and streptokinase was considered, we administered these two thrombolytic drugs together within 72 hours. conclucsion: ultimately we succeeded with this method without any significant or lifethreatening adverse effects, and the patient was discharged after an optimal anticoagulation therapy.