Tissue plasminogen activator for a left atrial thrombus after Senning repair.
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.
Tissot
Cecile
C
Pediatric Cardiology Unit, Department of Pediatrics, Children's University Hospital of Geneva, Geneva, Switzerland.
Rimensberger
Peter C
PC
Aggoun
Yacine
Y
Kalangos
Afksendyios
A
Ozsahin
Hulya
H
Beghetti
Maurice
M
da Cruz
Eduardo M
EM
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
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator