title: Tissue plasminogen activator for a left atrial thrombus after Senning repair.
abstract: OBJECTIVE
  To avoid the surgical removal of an obstructive thrombus in a Senning baffle by the administration of recombinant tissue-type plasminogen activator.
  
  
  METHODS
  A pediatric intensive care unit in a children's university hospital.
  
  
  METHODS
  A 3-yr-old male was diagnosed with a large left atrial thrombus 2 wks after Senning repair for D-transposition of the great arteries. The child presented with massive chylous pleural, pericardial effusions, and cardiac tamponade, secondary to partial obstruction of the pulmonary venous channel.
  
  
  METHODS
  Thrombolysis with recombinant tissue-type plasminogen activator was instituted.
  
  
  RESULTS
  We observed a resolution of the thrombus in <48 hrs. Minor local bleeding was the only noted side effect. No signs of systemic thromboembolization were detected.
  
  
  CONCLUSIONS
  Early thrombolysis with recombinant tissue-type plasminogen activator could be considered a possible alternative to surgical thrombectomy in selected postoperative pediatric cases, although there may be a potential risk of serious bleeding.
authors.affiliation: Pediatric Cardiology Unit, Department of Pediatrics, Children's University Hospital of Geneva, Geneva, Switzerland.
authors.forename: Cecile
authors.initials: C
authors.lastname: Tissot
authors.forename: Peter C
authors.initials: PC
authors.lastname: Rimensberger
authors.forename: Yacine
authors.initials: Y
authors.lastname: Aggoun
authors.forename: Afksendyios
authors.initials: A
authors.lastname: Kalangos
authors.forename: Hulya
authors.initials: H
authors.lastname: Ozsahin
authors.forename: Maurice
authors.initials: M
authors.lastname: Beghetti
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: da Cruz
mesh_terms: D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation; D002675:Child, Preschool; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006325:Heart Atria; D006331:Heart Diseases / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014188:Transposition of Great Vessels / Q000601:surgery
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator