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PubMed2004

Successful thrombolysis of acute left atrial thrombi in two pediatric patients following interventional cardiac catheterization.

Acute left atrial intracardiac thrombi require aggressive therapy due to the risk of embolization and cerebrovascular accidents. Current treatment includes the use of high-dose recombinant tissue plasminogen activator (rTPA), which is associated with significant bleeding complications. We report the successful treatment of two pediatric patients with acute left atrial thrombi following interventional cardiac catheterizations using low-dose rTPA. Echocardiography was used to document the presence of the thrombi and monitor treatment with rTPA infusion at 0.03 mg/kg/hour and heparin. Both patients experienced complete resolution of left atrial thrombi without hemodynamically significant side effects. Low-dose (0.03 mg/kg/hour) rTPA with heparin is an acceptable and safe alternative to high-dose rTPA infusion for intracardiac thrombi in children.

Abnormalities, Multiple↗

PubMed1995

Isolated pulmonary vein stenosis in complex congenital heart disease, simulating cor triatriatum by cardiac catheterization and transoesophageal echocardiography.

A case of localized stenosis of the lower left pulmonary vein, associated with perimembranous ventricular septal defect (VSD) and secundum atrial defect (ASD), a borderline sized mitral valve apparatus and left ventricle, is described. This final diagnosis was made at surgery, as the localized stenosis of the left pulmonary vein was misinterpreted as partial cor triatriatum by cardiac catheterization, cineangiocardiography and extensive echocardiographic studies. Surgical correction of all the defects was successful, but pulmonary vascular resistance was still increased 2 years after surgery.

Cardiac Catheterization↗

PubMed1991

A case of unusual longevity of tetralogy of Fallot confirmed by cardiac catheterization.

We describe a 61-year-old woman with tetralogy of Fallot and dextrocardia with complete situs inversus. The functional status of this patient was New York Heart Association (NYHA) class II and the systemic blood pressure was 100/54 mmHg. The hematocrit was 54.4% and the arterial partial pressure of oxygen was 53 mmHg. On cardiac catheterization, both pulmonary valvular and infundibular stenoses were of equal severity and the aorta and main pulmonary artery were of equal size. We think that this patient has survived to this unusual age for tetralogy of Fallot because of unusually low systemic pressure and a proper balance between the ventricular septal defect and the pulmonary stenosis.

Cardiac Catheterization↗

PubMed2003