Thrombolytic therapy for left-sided prosthetic valve occlusion is a viable alternative to surgery. The phenomenon of delayed opening of a bileaflet valve is a peculiar feature of thrombolytic therapy. Of 64 patients who received thrombolytic therapy and presented on 71 occasions, partial success was observed in 28 patients on completion of treatment. Of these 28 patients, delayed opening of the leaflets was observed in 14 (50%) over a period of 3 to 12 months. We suggest that this unique feature of bileaflet valves might delay or avoid reoperation. The need for frequent follow-up of patients with partially successful thrombolytic therapy is emphasized.
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