title: Combined rTPA and aspirin therapy for intracardiac thrombosis in neonates.
abstract: 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.
authors.affiliation: Santa Casa de Misericórdia de Vitória, UTI da Criança, Hospital Infantil Nossa Senhora da Glória, Vila Velha, ES, Brazil. ferdialmeida@hotmail.com
authors.forename: Fernanda Almeida
authors.initials: FA
authors.lastname: Tardin
authors.forename: Antônio Carlos
authors.initials: AC
authors.lastname: Avanza
authors.forename: Marcos Rogério Arantes
authors.initials: MR
authors.lastname: Andião
authors.forename: Sônia Maria Alves Andrade
authors.initials: SM
authors.lastname: Rabello
authors.forename: Emília de Mattos Gouvêa
authors.initials: Ede M
authors.lastname: Cristello
authors.forename: Edna Cellis Vaccari
authors.initials: EC
authors.lastname: Baltan
authors.forename: Edelweiss Bussinguer Pereira
authors.initials: EB
authors.lastname: Pegurin
authors.forename: Norma Suely
authors.initials: NS
authors.lastname: Oliveira
mesh_terms: 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
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator; D001241:Aspirin