Table 4

Fibrinolysis Versus Surgery for Prosthetic Valve Thrombosis

Favor SurgeryFavor Fibrinolysis
Readily available surgical expertiseNo surgical expertise available
Low surgical riskHigh surgical risk
Contraindication to fibrinolysisNo contraindication to fibrinolysis
Recurrent valve thrombosisFirst-time episode of valve thrombosis
NYHA class IVNYHA class I–III
Large clot (>0.8 cm2)Small clot (≤0.8 cm2)
Left atrial thrombusNo left atrial thrombus
Concomitant CAD in need of revascularizationNo or mild CAD
Other valve diseaseNo other valve disease
Possible pannusThrombus visualized
Patient choicePatient choice

CAD indicates coronary artery disease; and NYHA, New York Heart Association.