title: Complete Blalock-Taussig shunt obstruction in < 24 hours post-operative period in a neonate treated emergently using transcatheter angioplasty and low dose local recombinant TPA.
abstract: A 12-day-old infant with pulmonary atresia, intact ventricular septum, and pulmonary blood flow through a ductus arteriosus developed complete shunt obstruction within 12 hr of creation of a modified Blalock-Taussig shunt. Low dose recombinant tissue plasminogen activator was administered locally as two 0.03 mg/kg bolus injections and was followed by balloon angioplasty. This resulted in complete recanalization of the shunt without any hemorrhagic complications.
authors.affiliation: Carman and Ann Adams Department of Pediatrics, Division of Pediatric Cardiology, Children's Hospital of Michigan, Detroit, Michigan.
authors.forename: Amit
authors.initials: A
authors.lastname: Patange
authors.forename: Jennifer
authors.initials: J
authors.lastname: Blake
authors.forename: Srinath
authors.initials: S
authors.lastname: Gowda
mesh_terms: D000800:Angioplasty, Balloon; D058366:Blalock-Taussig Procedure / Q000009:adverse effects*; D003131:Combined Modality Therapy; D004630:Emergencies; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator
keywords: pediatric interventions; thrombosis; total occlusions