title: Systemic thrombolysis with recombinant tissue plasminogen activator for acute life-threatening Blalock-Taussig shunt obstruction.
abstract: Modified Blalock-Taussig shunt (mBTS) obstruction can be life-threatening, especially when it represents the only source of pulmonary blood flow. Current therapeutic options to reverse obstruction include surgical shunt revision/replacement, interventional endovascular procedures including balloon angioplasty and/or stent placement, and a combination of local and systemic thrombolytic therapy. We report two cases of acute mBTS thrombosis successfully treated with systemic recombinant tissue plasminogen activator in infants convalescing after cardiac surgery when the clinical status and resources precluded traditionally described rescue therapies.
authors.affiliation: Division of Pediatric Critical Care Medicine, Section of Cardiac Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Franco
authors.initials: F
authors.lastname: Diaz
authors.affiliation: Division of Pediatric Critical Care Medicine, Section of Cardiac Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Sasser
authors.affiliation: Division of Pediatric Cardiology, Section of Cardiac Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Law
authors.affiliation: Division of Pediatric Cardiology, Section of Cardiac Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Alten
keywords: Congenital heart disease; fibrinolysis; shunt thrombosis; tissue plasminogen activator