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8. Mikrozirkulation

Author

Strauer, B. E., von Wichert, P., Leschke, M., Samtleben, W., Poralla, T., Motz, W., Vogt, M., Scheler, S., Schwartzkopff, B., Lanser, K., Hennerici, M. G., and Miehlke, Klaus, editor

Published
1991
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21. Das Herz bei Stoffwechselerkrankungen

Author

Frenzel, H., primary, Schwartzkopff, B., additional, Hort, W., additional, Schnabel, Ph. A., additional, Bürrig, K.-F., additional, Arnold, G., additional, Sergi, C., additional, and Numrich, P., additional

Published
2000
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34. Successful Thrombolysis of St. Jude Medical Aortic Prosthesis with Tissue-Type Plasminogen Activator in a Pregnant Woman: A Case Report

Author

Strauer Be, Behrendt P, Gerhardt A, Zotz Rb, Schwartzkopff B, and Perings S

Subjects
Adult, Aortic valve, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Pregnancy Complications, Cardiovascular, Heart Valve Diseases, Low molecular weight heparin, Tissue plasminogen activator, Pregnancy, medicine, Humans, Thrombolytic Therapy, business.industry, Warfarin, Thrombosis, General Medicine, Thrombolysis, Heparin, medicine.disease, Prosthesis Failure, Surgery, medicine.anatomical_structure, Aortic Valve, Heart Valve Prosthesis, Tissue Plasminogen Activator, Female, Cardiology and Cardiovascular Medicine, business, Plasminogen activator, medicine.drug
Abstract

Mechanical valve thrombosis is a life-threatening event. Pregnancy is associated with a hypercoagulable state that further emphasizes the importance of adequate anticoagulation. This is associated with a therapeutic dilemma. Continued anticoagulation with warfarin throughout the first trimester can result in fetopathic effects, while replacement of warfarin by heparin between 6 and 12 weeks of gestation does not completely prevent the risk of valve thrombosis. There are a small number of reported cases of pregnant women with prosthetic heart valve thrombosis under low molecular weight heparin and consecutive lytic therapy. The authors report a 33-year-old pregnant woman with a St. Jude Medical aortic prosthesis, anticoagulated with a therapeutic dosage of low molecular weight heparin from 6 weeks of gestation, who developed prosthetic heart valve thrombosis at 17 weeks of gestation. A thrombolysis with recombinant tissue-type plasminogen activator (50 mg for 2 hours) was performed. Under thrombolysis, ST-segment elevation in leads II, III, aVF, V5, and V6 developed electrocardiographically with a maximal creatine kinase (CK) of 349 U/L (CK-MB isoenzyme of 48 U/L). Echocardiography revealed normal function of the St. Jude Medical aortic prosthesis 2 hours after thrombolysis and normal wall motions. Short-course thrombolytic therapy appears to be an effective alternative to surgical intervention for the treatment of thrombotic dysfunction of valve prostheses in pregnancy.

Published
2002

50. Dipyridamol intrakoronar reduziert die Inzidenz des akuten Koronargefäßverschlusses bei der perkutanen transluminalen Koronarangioplastie – Eine prospektiv randomisierte Untersuchung (The incidence of acute coronary occlusions after percutaneous transluminal coronary angioplasty is reduced by intracoronary application of dipyridamole – A prospective randomized trial)

Author

Heintzen, M.P., primary, Heidland, U.E., additional, Klimek, W.J., additional, Michel, C.J., additional, Kelm, M., additional, Leschke, M., additional, Schwartzkopff, B., additional, Vester, E.G., additional, and Strauer, B.E., additional

Published
1997
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