en داروسازی بالینی Clinical Pharmacy گزارش مورد case report <div style="text-align: justify;"><strong>Introduction: </strong>Prosthetic valve thrombosis is a rare and severe complication of valve replacement, most often encountered with a mechanical prosthesis. The significant morbidity and mortality associated with this condition warrant rapid diagnostic evaluation. Although surgery is the first-line therapy in symptomatic obstructive mechanical valve thrombosis, thrombolytic therapy has been used as an alternative.&nbsp;<br> <strong>Case Description:</strong> In this case report, we describe a 46-year-old man with a history of the mitral valve and aortic valve replacement 2 years ago. In echocardiography, we detected a mobile mass on the atrial side of the mitral valve prosthesis and a fixed one on the leaflet of the mechanical aortic valve with a high gradient. To save his life, we used double thrombolytic therapy considering the patient&rsquo;s hemodynamic situation and the risk of bleeding. Although a routine dose of reteplase and streptokinase was considered, we administered these two thrombolytic drugs together within 72 hours.&nbsp;<br> <strong>Conclucsion:</strong> Ultimately we succeeded with this method without any significant or life-threatening adverse effects, and the patient was discharged after an optimal anticoagulation therapy.</div> Mitral valve, Aortic valve, Thrombolytic, Reteplase, Streptokinase 69 74 http://pbr.mazums.ac.ir/browse.php?a_code=A-10-759-1&slc_lang=en&sid=1 Shayesteh Gheibi شایسته غیبی shayestegheybi@yahoo.com 10031947532846005102 1368-0526-1989-0526 No Department of Clinical Pharmacy, Cardiovascular Research Center, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran. Aliasghar Farsavian علی اصغر فرسویان dralicardio@yahoo.com 10031947532846005103 1368-0526-1989-0526 No Department of Cardiology, School of Medicine Cardiovascular, Research Center, Sari Fatemeh Zahra Hospital, Mazandaran University of Medical Sciences, Sari, Iran. Maryam Nabati مریم نباتی dr.mr.nabati@gmail.com 10031947532846005104 1368-0526-1989-0526 No Department of Cardiology, School of Medicine Cardiovascular, Research Center, Sari Fatemeh Zahra Hospital, Mazandaran University of Medical Sciences, Sari, Iran. Gohar Eslami گوهر اسلامی dr.gohar.eslami@gmail.com 10031947532846005105 1368-0526-1989-0526 Yes Department of Clinical Pharmacy, Cardiovascular Research Center, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.