{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:16:27Z","timestamp":1790291787558,"version":"4.1.0"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951122001652_as1\"><jats:title>Introduction:<\/jats:title><jats:p>The incidence of prosthetic valve implantation is increasing in the paediatric population. Prosthetic valve thrombosis leading to obstruction could potentially be a life-threatening complication. There is a debate regarding optimal management of this complication, and there is limited use of thrombolytic therapy in childhood in the setting of valve thrombosis.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122001652_as2\"><jats:title>Objective:<\/jats:title><jats:p>We aim to share our experience of successfully using fibrinolytic therapy in terms of alteplase for paediatric prosthetic mitral valve thrombosis and to propose a management algorithm.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122001652_as3\"><jats:title>Methods:<\/jats:title><jats:p>This retrospective analysis of the database was conducted at our hospital including patients who underwent thrombolysis (alteplase) for prosthetic mitral valve thrombosis from June, 2011 to June, 2021. A total of 10 patients with 20 attempts of alteplase infusion were found in our record.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122001652_as4\"><jats:title>Results:<\/jats:title><jats:p>Alteplase was successful in 19 attempts to relieve valve thrombosis. The safe and effective dose of alteplase was between 0.1 and 0.3 mg\/kg\/hour. There were no associated major bleeding complications and alteplase was administered either by central or peripheral line.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122001652_as5\"><jats:title>Conclusion:<\/jats:title><jats:p>Thrombolysis by alteplase infusion was found to be successful in relief of prosthetic mitral valve thrombosis in paediatric population without major bleeding complications.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951122001652","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T06:12:57Z","timestamp":1654236777000},"page":"747-753","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Effectiveness of alteplase infusion for the management of prosthetic mitral valve thrombosis in paediatric age group and proposed algorithm"],"prefix":"10.1017","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9534-6076","authenticated-orcid":false,"given":"Mohamed H","family":"Mashali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaheer","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Omar Galal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amjad","family":"Al-Kouatli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,6,3]]},"reference":[{"key":"S1047951122001652_ref10","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2013.15.2.90"},{"key":"S1047951122001652_ref2","first-page":"e72","article-title":"2020 ACC\/AHA Guideline for the management of patients with valvular heart disease: a report of the american college of cardiology\/american heart association joint committee on clinical practice guidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"S1047951122001652_ref14","doi-asserted-by":"publisher","DOI":"10.1136\/fn.85.1.F66"},{"key":"S1047951122001652_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-015-1199-0"},{"key":"S1047951122001652_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.04.025"},{"key":"S1047951122001652_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2003.11.026"},{"key":"S1047951122001652_ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-020-01324-7"},{"key":"S1047951122001652_ref23","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3181d8d5eb"},{"key":"S1047951122001652_ref12","first-page":"790","article-title":"A successful thrombolytic therapy for thrombosed ATS valve in the mitral position in a child; report of a case. 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