Multimodality imaging and thrombolytic therapy for prosthetic valve thrombosis

n a l 1032 /European Association for Cardio-Thoracic Surgery (EACTS) guidelines still considers surgery to be the first-line therapy.The inconsistencies between these American and European guidelines regarding the recommendations for the management of PVT may be multifactorial.One might argue that the ESC/EACTS taskforce may be concerned about the safety of thrombolysis because no randomized data is yet available on this topic.However, it should be recognized that not all of the recommendations set out by guidelines are based on randomized trials.