3-3-3 Surgery
Surgical Procedures included valve replacement with either a new
mechanical or a bioprosthetic valve (n = 18, 90%), and previous valve
cleaning (n = 2, 10%). Organized thrombus or a combination of pannus
and thrombus was reported in 5 (71%) episodes of failed thrombolytic
therapy, while was noted in 4 (36.3%) episodes not receiving
fibrinolytic (p = 0.03). Complete hemodynamic and clinical success was
obtained in eighteen (90%). One death (5%) occurred after surgery in a
49-year-old man with a history of redo TV replacement and treated with a
strategy of slow (6 hours), single infusion of low-dose alteplase (50
mg) before surgery, and one patient (5%) was complicated with
non-hemorrhagic stroke following operation. The means of hospital stay
among patients underwent surgical procedure as a first step and those
after failed thrombolytic were 23.2 ± 19 and 24.5 ± 8.2 days,
respectively.