Acute pulmonary embolism in a neonate: precipitation during cardiac catheterization and successful treatment.
This report illustrates the rare occurrence of a pulmonary embolus in a neonate during cardiac catheterization. The patient was a term newborn who underwent repair of obstructed infradiaphragmatic total anomalous pulmonary venous connection. Postoperative risk factors for pulmonary embolism included severe pulmonary hypertension unresponsive to nitric oxide therapy, an indwelling venous catheter, and young age. Successful management was achieved by initial mechanical fragmentation with streptokinase infusion and monitoring by serial lung perfusion scans.
Departments of Cardiology, Cardiac Surgery and Nuclear Medicine, Children's Hospital, Harvard Medical School, Boston, MA, USA.
L
L
Abdurrahman
I
I
Adatia
J E
JE
Mayer
P
P
Moore
S T
ST
Treves
D000208:Acute Disease; D000714:Anastomosis, Surgical; D006328:Cardiac Catheterization; D017809:Fatal Outcome; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D011667:Pulmonary Veins / Q000002:abnormalities / Q000601:surgery; D011877:Radionuclide Imaging; D013300:Streptokinase / Q000627:therapeutic use; D015912:Thrombolytic Therapy
D005343:Fibrinolytic Agents; D013300:Streptokinase