title: Successful thrombolysis of acute left atrial thrombi in two pediatric patients following interventional cardiac catheterization.
abstract: Acute left atrial intracardiac thrombi require aggressive therapy due to the risk of embolization and cerebrovascular accidents. Current treatment includes the use of high-dose recombinant tissue plasminogen activator (rTPA), which is associated with significant bleeding complications. We report the successful treatment of two pediatric patients with acute left atrial thrombi following interventional cardiac catheterizations using low-dose rTPA. Echocardiography was used to document the presence of the thrombi and monitor treatment with rTPA infusion at 0.03 mg/kg/hour and heparin. Both patients experienced complete resolution of left atrial thrombi without hemodynamically significant side effects. Low-dose (0.03 mg/kg/hour) rTPA with heparin is an acceptable and safe alternative to high-dose rTPA infusion for intracardiac thrombi in children.
authors.affiliation: Department of Pediatrics, Section of Cardiology, Steele Memorial Children's Research Center, The University of Arizona, Tucson, AZ 87524, USA.
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Herron
authors.forename: Daniela
authors.initials: D
authors.lastname: Lax
authors.forename: Rolando
authors.initials: R
authors.lastname: Zamora
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000628:therapy; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents