{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:59:44Z","timestamp":1788919184755,"version":"build-2803163510"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,7,30]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Prosthetic valve thrombosis during pregnancy is life-threatening for mother and fetus, and the treatment of this complication is unclear. Cardiac surgery in pregnancy is associated with very high maternal and fetal mortality and morbidity. Thrombolytic therapy has rarely been used in these patients. The aim of this study is to evaluate the safety and efficacy of low-dose (25 mg), slow infusion (6 hours) of tissue-type plasminogen activator for the treatment of prosthetic valve thrombosis in pregnant women.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>Between 2004 and 2012, tissue-type plasminogen activator was administered to 24 consecutive women in 25 pregnancies with 28 prosthetic valve thrombosis episodes (obstructive, n=15; nonobstructive, n=13). Mean age of the patients was 29\u00b16 years. Thrombolytic therapy sessions were performed under transesophageal echocardiography guidance. The mean dose of tissue-type plasminogen activator used was 48.7\u00b129.5 mg (range, 25\u2013100mg). All episodes resulted in complete thrombus lysis after thrombolytic therapy. One patient had placental hemorrhage with preterm live birth at the 30th week, and 1 patient had minor bleeding.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Low-dose, slow infusion of tissue-type plasminogen activator with repeated doses as needed is an effective therapy with an excellent thrombolytic success rate for the treatment of prosthetic valve thrombosis in pregnant women. This protocol also seems to be safer than cardiac surgery or any alternative medical strategies published to date. Thrombolytic therapy should be considered first-line therapy in pregnant patients with prosthetic valve thrombosis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.113.001145","type":"journal-article","created":{"date-parts":[[2013,6,29]],"date-time":"2013-06-29T07:45:55Z","timestamp":1372491955000},"page":"532-540","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":158,"title":["Thrombolytic Therapy for the Treatment of Prosthetic Heart Valve Thrombosis in Pregnancy With Low-Dose, Slow Infusion of Tissue-Type Plasminogen Activator"],"prefix":"10.1161","volume":"128","author":[{"given":"Mehmet","family":"\u00d6zkan","sequence":"first","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beytullah","family":"\u00c7akal","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00fcleyman","family":"Karakoyun","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozan Mustafa","family":"G\u00fcrsoy","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cihan","family":"\u00c7evik","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Macit","family":"Kal\u00e7\u0131k","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Emrah","family":"O\u011fuz","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabahattin","family":"G\u00fcnd\u00fcz","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Ali","family":"Astarcioglu","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet \u00c7a\u011fr\u0131","family":"Aykan","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z\u00fcbeyde","family":"Bayram","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Biteker","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evren","family":"Kaynak","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6khan","family":"Kahveci","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nil\u00fcfer Ek\u015fi","family":"Duran","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Y\u0131ld\u0131z","sequence":"additional","affiliation":[{"name":"From the Kosuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, \u0130stanbul, Turkey (M.\u00d6, B.\u00c7, S.K., O.M.G., M.K., A.E.O., S.G., M.A.A., A.\u00c7.A., Z.B., M.B., G.K., N.E.D., M.Y.); Texas Heart Institute at St. Luke\u2019s Episcopal Hospital, Baylor College of Medicine, Division of Adult Cardiology, Houston (C.\u00c7.); and University of Texas Health Science Center, Division of Adult Cardiology, Houston (E.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/107424840400900206"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.2.191"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02299.x"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs109"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.05.007"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70039-0"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2012.10.016"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0268-9499(88)90030-6"},{"key":"e_1_3_3_10_2","first-page":"425","article-title":"Thrombosis of a mitral valve prosthesis in a pregnant woman: treatment with streptokinase [in French].","volume":"18","author":"Moisson P","year":"1979","unstructured":"Moisson P, Cornier E, Rozensztajn L, Catinat J. 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