title: Tissue plasminogen activator for neonatal coronary thrombosis presenting with mitral valve regurgitation and impaired ventricular function.
abstract: OBJECTIVE
  Neonatal coronary thrombosis is a rarely reported disorder, with variable outcomes described. This study assessed the feasibility and safety of an institutional protocol using tissue plasminogen activator (tPA) administration for the treatment of neonatal coronary artery thrombi.
  
  
  METHODS
  They reviewed the outcome of three neonates with clinical evidence of myocardial infarction secondary to coronary thrombosis. All three underwent the tPA treatment protocol.
  
  
  RESULTS
  The three described cases presented at 5 hours, 15 hours, and 10 days of life. The patients identified underwent the tPA protocol at least once. There was clinical evidence of improvement in coronary flow, as well as demonstration of increased left ventricular function and decreased mitral regurgitation. No major adverse events occurred.
  
  
  CONCLUSIONS
  Thrombolytic therapy with this tPA protocol may be safe and effective in treating neonates with coronary thrombosis.
authors.affiliation: Rady Children's Hospital, San Diego, University of California, San Diego, California, USA.
authors.forename: Delaram
authors.initials: D
authors.lastname: Molkara
authors.affiliation: Rady Children's Hospital, San Diego, University of California, San Diego, California, USA.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Silva Sepulveda
authors.affiliation: Rady Children's Hospital, San Diego, University of California, San Diego, California, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Do
authors.affiliation: Rady Children's Hospital, San Diego, University of California, San Diego, California, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Davis
authors.affiliation: Rady Children's Hospital, San Diego, University of California, San Diego, California, USA.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Goldstein
authors.affiliation: Rady Children's Hospital, San Diego, University of California, San Diego, California, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: Moore
authors.affiliation: Rady Children's Hospital, San Diego, University of California, San Diego, California, USA.
authors.forename: Howaida G
authors.initials: HG
authors.lastname: El-Said
mesh_terms: D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: coronary thrombus; neonatal impaired ventricular function; neonatal mitral regurgitation; tPA