title: Intra-atrial tissue plasminogen activator infusion for prosthetic valve thrombosis.
abstract: Thrombosis is a well-known and life-threatening complication of prosthetic mechanical valves. Therapy typically requires medical thrombolysis or surgical thrombectomy/valve replacement. We report the case of a thrombosed atrioventricular valve in a young boy with complex congenital heart disease, which was successfully treated with direct intra-atrial infusion of recombinant tissue plasminogen activator after failed attempts at systemic therapy. We present this treatment as an alternative to conventional medical therapy.
authors.affiliation: Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Seltzer
authors.forename: Michael D
authors.initials: MD
authors.lastname: Reed
authors.forename: Ernest S
authors.initials: ES
authors.lastname: Siwik
mesh_terms: D002648:Child; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006349:Heart Valve Diseases / Q000188:drug therapy*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D017211:Treatment Failure
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator