Combined rTPA and aspirin therapy for intracardiac thrombosis in neonates.
We describe a case of a very low birth weight premature female twin with intracardiac thrombosis. Her condition was consistent with neonatal sepsis, and she was treated with advanced life support, antibiotic therapy, parenteral nutrition, blood transfusion, and central venous catheterization. Infective endocarditis was suspected, and a large intracavitary thrombus was detected by two-dimensional Doppler echocardiography. Surgical procedure was not only technically difficult but also highly lethal, being contraindicated in some cases. Consequently, the use of the thrombolytic recombinant tissue-plasminogen activator (rTPA) associated with aspirin was the treatment of choice, and complete dissolution of the thrombus was achieved without adverse effects.
Tardin
Fernanda Almeida
FA
Santa Casa de Misericórdia de Vitória, UTI da Criança, Hospital Infantil Nossa Senhora da Glória, Vila Velha, ES, Brazil. ferdialmeida@hotmail.com
Avanza
Antônio Carlos
AC
Andião
Marcos Rogério Arantes
MR
Rabello
Sônia Maria Alves Andrade
SM
Cristello
Emília de Mattos Gouvêa
Ede M
Baltan
Edna Cellis Vaccari
EC
Pegurin
Edelweiss Bussinguer Pereira
EB
Oliveira
Norma Suely
NS
D001241:Aspirin / Q000627:therapeutic use*; D004200:Diseases in Twins / Q000000981:diagnostic imaging / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D011994:Recombinant Proteins / Q000627:therapeutic use; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D014463:Ultrasonography
D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator; D001241:Aspirin