title: [Recombinant tissue plasminogen activator for the management of intracardiac thrombi in newborns].
abstract: BACKGROUND
  The incidence of cardiac thrombi in newborns has increased with the use of central venous catheters. Thrombolysis with recombinant tissue plasminogen activator (rTPA) has been used as an alternative to heparin in life threatening giant thrombus and embolization. The aim of this study is to describe the response and complications related to the use of rTPA in the management of life- threatening cardiac thrombi in newborns.
  
  
  METHODS
  The medical records of 8 newborn were reviewed in a retrospective study, of whom 7 were preterm with cardiac thrombi, and rTPA was used in all of them.
  
  
  RESULTS
  The patients included 4 males with a mean weight of 1580 gr. The principal pathology was sepsis (7/8), all of them used venous central catheter. The superior vena cava was the most frequent location, with a mean time of installation before the diagnosis of 12 days. RN 7/8 thrombi were located in the right atrium with a size between 7 to 20 mm. Three patients received low molecular weight heparin prior to using rTPA. They received between 1 to 5 cycles with rTPA. In 4 patients complete resolution of the thrombus was achieved in a mean of 3.5 days. Four patients had intracranial haemorrhage grade I, without sequelae at follow-up. There were no deaths or embolism.
  
  
  CONCLUSIONS
  This study is the first series of infants treated with rTPA in Chile, and where its use has quickly achieved complete resolution of the thrombus in 50% of cases, and partially in the others, thus reducing the secondary life-threatening risk of this disease.
authors.affiliation: Hospital Roberto del Río, Santiago, Chile; Departamento de Pediatría Norte, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Clínica Alemana de Santiago, Santiago, Chile. Electronic address: pazenteno@yahoo.com.
authors.forename: Patricia
authors.initials: P
authors.lastname: Álvarez Z
authors.affiliation: Hospital Roberto del Río, Santiago, Chile; Departamento de Pediatría Norte, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Clínica Santa María, Santiago, Chile.
authors.forename: Patricia
authors.initials: P
authors.lastname: Verdugo L
authors.affiliation: Hospital Roberto del Río, Santiago, Chile.
authors.forename: Luis
authors.initials: L
authors.lastname: Carvajal K
authors.affiliation: Departamento de Pediatría Norte, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Servicio de Neonatología, Hospital San José, Santiago, Chile.
authors.forename: Germán
authors.initials: G
authors.lastname: Múhlhausen M
authors.affiliation: Alumno de Medicina, Universidad de Chile, Santiago, Chile.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ríos A
authors.affiliation: Alumno de Medicina, Universidad Finis Terrae, Santiago, Chile.
authors.forename: Diego
authors.initials: D
authors.lastname: Rodríguez V
mesh_terms: D062905:Central Venous Catheters; D002677:Chile; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000188:drug therapy* / Q000473:pathology; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods; D013927:Thrombosis / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D006493:Heparin; D010959:Tissue Plasminogen Activator
keywords: Activador plasminógeno tisular recombinante; Intracardiac thrombi; Neonatal thrombolysis; Recombinant tissue plasminogen activator; Trombos cardiacos; Trombólisis neonatal