Successful treatment of ventricular assist device associated ventricular thrombus with systemic tenecteplase.
We report a case of intracardiac thrombus in a patient supported by the Jarvik 2000 Flowmaker successfully treated with a single dose of peripherally administered TNK-tissue plasminogen activator (Tenecteplase, Metalyse, Boehringer Ingelheim). This strategy may be considered in the case of life-threatening VAD associated thrombosis to avoid the need for intracardiac drug delivery or VAD replacement. We also discuss the apparent increased thrombotic risk in patients receiving a VAD for chemotherapy induced cardiomyopathy and the implications this may have for the choice of VAD.
Hayes
H
H
Advanced Heart Failure & Cardiac Transplant Service, Royal Perth Hospital, Perth, Western Australia, Australia. helen.hayes@health.wa.gov.au
Dembo
L
L
Larbalestier
R
R
O'Driscoll
G
G
D000328:Adult; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006352:Heart Ventricles / Q000473:pathology; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D000077785:Tenecteplase; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase