RecentRCT

Urgent surgery versus fibrinolysis for PVT

Urgent surgery vs fibrinolytic therapy for left-sided prosthetic valve thrombosis: a randomized trial.

European heart journal, 2025 · Single-center randomized trial

Population: 79 symptomatic left-sided mechanical PVT patients
Intervention: Urgent surgery
Comparator: Low-dose slow tPA
Primary outcome: Complete clinical response at discharge
Result: No significant response difference, OR 1.22 (0.46–3.19). Safety composite more frequent with surgery, OR 5.14 (1.28–20.5); 25% lysis residual dysfunction.

What the trial found

No significant response difference, OR 1.22 (0.46–3.19). Safety composite more frequent with surgery, OR 5.14 (1.28–20.5); 25% lysis residual dysfunction.

Clinical interpretation

Single-center expertise, wide intervals and residual dysfunction constrain universal treatment choices.

Low certainty

Clinical Context & Relevant Topics (1)

Disease Reference

Valvular Heart Disease & Infective Endocarditis in the ICU

Critical AS, acute AR/MR mechanics, prosthetic valve emergencies, and infective endocarditis with multidisciplinary surgical triggers.

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