title: Successful treatment of ventricular assist device associated ventricular thrombus with systemic tenecteplase.
abstract: 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.
authors.affiliation: Advanced Heart Failure & Cardiac Transplant Service, Royal Perth Hospital, Perth, Western Australia, Australia. helen.hayes@health.wa.gov.au
authors.forename: H
authors.initials: H
authors.lastname: Hayes
authors.forename: L
authors.initials: L
authors.lastname: Dembo
authors.forename: R
authors.initials: R
authors.lastname: Larbalestier
authors.forename: G
authors.initials: G
authors.lastname: O'Driscoll
mesh_terms: 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*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase