Intravenous streptokinase was used as an emergency treatment for acute thrombotic obstruction of a Björk-Shiley prosthesis in the mitral position. Transoesophageal echocardiography established the diagnosis and was used to monitor the clinical response to treatment. Because the patient was haemodynamically stable after thrombolysis and because transoesophageal echocardiography showed that the prosthesis was free of thrombus the mitral prosthesis was not replaced.
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