American Society of Hirudotherapy

Successful Thrombolytic Therapy forMechanical Mitral Valve ThrombosisUsing Bivalirudin-Based Thrombolytic Regimen

Case report published in JACC. Case reports (2025)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsSafety & Infection ControlAlaiwah M et al. · JACC. Case reports, 2025

Abstract

Distinguishing the cause of a mechanical valve obstruction as a thrombus or a pannus can be difficult but is critical because pannus can be treated only with surgical valve replacement and thrombus can be treated with surgery or fibrinolytic therapy. This case report describes a patient with a mechanical valve thrombosis and reported allergy to porcine products who was treated by an unusual regimen: ultraslow-infusion, low-dose fibrinolytic therapy with administration of bivalirudin as a bridging anticoagulant.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeCase ReportsJournal Article

Summary

Distinguishing the cause of a mechanical valve obstruction as a thrombus or a pannus can be difficult but is critical because pannus can be treated only with surgical valve replacement and thrombus can be treated with surgery or fibrinolytic therapy.

Why This Matters for Hirudotherapy

This case report describes a patient with mechanical valve thrombosis and a reported allergy to porcine products who was treated with ultra-slow-infusion, low-dose fibrinolytic therapy, using bivalirudin as a bridging anticoagulant. The abstract makes no mention of leeches, hirudotherapy, hirudin, or any leech-derived compounds, and provides no basis for connecting bivalirudin to the leech secretome or hirudotherapy. This is a single case report focused on a novel fibrinolytic regimen for valve thrombosis in a patient with specific allergies. There is no defensible leech-related relevance to ASH's domain based solely on this abstract.

Citation

Successful Thrombolytic Therapy forMechanical Mitral Valve ThrombosisUsing Bivalirudin-Based Thrombolytic Regimen

Alaiwah M et al. · JACC. Case reports, 2025

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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