Catheter-Guided Dissolution of a Giant Thrombus in the Left Ventricle in a Newborn

Jacek Kuźma; Maciej A Karolczak; Bożena Kociszewska-Najman; Jacek Pająk; Michał Buczyński; Wojciech Mądry; Katarzyna Szymańska-Beta; Darren J Grégoire

doi:10.1016/j.jaccas.2020.11.027

Catheter-Guided Dissolution of a Giant Thrombus in the Left Ventricle in a Newborn

JACC Case Rep. 2021 Feb 3;3(2):220-224. doi: 10.1016/j.jaccas.2020.11.027. eCollection 2021 Feb.

Authors

Jacek Kuźma¹, Maciej A Karolczak¹, Bożena Kociszewska-Najman², Jacek Pająk¹, Michał Buczyński¹, Wojciech Mądry¹, Katarzyna Szymańska-Beta³, Darren J Grégoire¹

Affiliations

¹ Department of Cardiac and General Pediatric Surgery, Medical University of Warsaw, Warsaw, Poland.
² Department of Neonatology, Medical University of Warsaw, Warsaw, Poland.
³ Department of Pediatric Anesthesiology and Intensive Therapy, Medical University of Warsaw, Warsaw, Poland.

Abstract

A newborn with pulmonary hypertension due to the premature fetal arterial duct occlusion was diagnosed with a giant left ventricle thrombus. Cardiopulmonary compromise required multidrug therapy with vasopressors infusions, high-frequency oscillation, and nitric oxide. Alteplase infusion through a guiding catheter into the left atrium dissoluted the clot without sequelae. (Level of Difficulty: Advanced.).

Keywords: FO, foramen ovale; LA, left atrium; LV, left ventricle; RA, right atrium; RR, reference range; RV, right ventricle; TTE, transthoracic echocardiogram; anticoagulation; atrial flutter; left-sided catheterization; pulmonary hypertension; rTPA, recombinant tissue plasminogen activator; thrombus.

Publication types

Case Reports