Catheter-directed thrombolysis with recombinant tissue plasminogen activator for acute pulmonary embolism after fontan operation.
We report the case of a 3-year-old girl who presented with near-lethal pulmonary thrombembolism 3 weeks after an uneventful Fontan operation. Complete occlusion of the left lower lobe pulmonary artery had occurred together with a cerebral infarction. Recombinant tissue plasminogen activator (rt-Pa) was used for thrombolysis because of its short half-life and its clot-selective properties. To further minimize the systemic effects of rt-PA, local catheter-directed lysis was performed. A prolonged course of low-dose rt-PA therapy achieved complete lysis without side effects.
Beitzke
A
A
Department of Pediatric Cardiology, Kinderklinik, University of Graz, Auenbruggerplatz, A-8036 Graz, Austria.
Zobel
G
G
Zenz
W
W
Gamillscheg
A
A
Stein
J I
JI
D002404:Catheterization; D002544:Cerebral Infarction / Q000209:etiology; D002675:Child, Preschool; D005260:Female; D018729:Fontan Procedure; D006801:Humans; D011183:Postoperative Complications / Q000188:drug therapy*; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000209:etiology; D011994:Recombinant Proteins / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator