title: Thrombolytic therapy for right heart lesions.
abstract: Thrombolytic agents are accepted therapy for occlusion of coronary and peripheral arteries as well as for venous thromboses. Although the treatment of left heart prosthetic valve thrombosis has been evaluated, there are limited data showing the benefit of thrombolysis of right heart clots. Two patients with past histories of multiple cardiac operations were given fibrinolytic therapy for thrombosis involving right heart structures. The first patient had thrombosis of a prosthetic pulmonary valve. The second patient was a type IB tricuspid atresia who developed a Fontan duct stenosis and right atrial clot. Thrombolytic therapy may provide a safe alternative to surgical intervention for thrombosis of right heart structures and, even when incompletely effective, may provide additional time to prepare patients for surgical correction and possible protection against distal embolization during surgical intervention.
authors.affiliation: Division of Cardiology, Walter C Mackenize Health Sciences Centre, Edmonton, Alberta.
authors.forename: A
authors.initials: A
authors.lastname: Yunus
authors.forename: C A
authors.initials: CA
authors.lastname: Basualdo
authors.forename: K
authors.initials: K
authors.lastname: Kavanagh
mesh_terms: D000328:Adult; D016280:Atrial Function, Right / Q000187:drug effects; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000187:drug effects*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011664:Pulmonary Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D011994:Recombinant Proteins / Q000008:administration & dosage; D012086:Reoperation; D013300:Streptokinase / Q000008:administration & dosage; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging / Q000601:surgery*; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D016278:Ventricular Function, Right / Q000187:drug effects
chemical_list: D011994:Recombinant Proteins; D013300:Streptokinase; D010959:Tissue Plasminogen Activator