Treatment of intracardiac thrombi using ultra-slow low-dose thrombolytic therapy : A case report
Copyright © 2023. Publicado por Elsevier España, S.L.U..
A 57-year-old male with previously known severe primary mitral regurgitation was admitted to the intensive care unit (ICU) due to massive venous thromboembolism, associated with right ventricular dysfunction and two large mobile right atrial thrombi. Due to deterioration in his clinical condition despite standard treatment with unfractionated heparin, it was decided to use an ultra-slow low-dose thrombolysis protocol, which consisted of a 24-hour infusion of 24 mg of alteplase at a rate of 1 mg per hour, without initial bolus. The treatment was continued for 48 consecutive hours, with clinical improvement and resolution of the intracardiac thrombi and no complications. One month after ICU admission, successful mitral valve repair surgery was conducted. This case demonstrates that ultra-slow low-dose thrombolysis is a valid bailout treatment option in patients with large intracardiac thrombi refractory to the standard approach.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology - 42(2023), 11 vom: 06. Nov., Seite 925-928 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Alves Pinto, Ricardo [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 06.11.2023 Date Revised 08.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.repc.2019.09.023 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 520 | |a Copyright © 2023. Publicado por Elsevier España, S.L.U. | ||
| 520 | |a A 57-year-old male with previously known severe primary mitral regurgitation was admitted to the intensive care unit (ICU) due to massive venous thromboembolism, associated with right ventricular dysfunction and two large mobile right atrial thrombi. Due to deterioration in his clinical condition despite standard treatment with unfractionated heparin, it was decided to use an ultra-slow low-dose thrombolysis protocol, which consisted of a 24-hour infusion of 24 mg of alteplase at a rate of 1 mg per hour, without initial bolus. The treatment was continued for 48 consecutive hours, with clinical improvement and resolution of the intracardiac thrombi and no complications. One month after ICU admission, successful mitral valve repair surgery was conducted. This case demonstrates that ultra-slow low-dose thrombolysis is a valid bailout treatment option in patients with large intracardiac thrombi refractory to the standard approach | ||
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| 650 | 4 | |a Mitral valve insufficiency | |
| 650 | 4 | |a Pulmonary embolism | |
| 650 | 4 | |a Thrombolytic therapy | |
| 650 | 4 | |a Tromboembolismo pulmonar | |
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