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.