title: Catheter-directed thrombolysis with recombinant tissue plasminogen activator for acute pulmonary embolism after fontan operation.
abstract: 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.
authors.affiliation: Department of Pediatric Cardiology, Kinderklinik, University of Graz, Auenbruggerplatz, A-8036 Graz, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Beitzke
authors.forename: G
authors.initials: G
authors.lastname: Zobel
authors.forename: W
authors.initials: W
authors.lastname: Zenz
authors.forename: A
authors.initials: A
authors.lastname: Gamillscheg
authors.forename: J I
authors.initials: JI
authors.lastname: Stein
mesh_terms: 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*
chemical_list: D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator