Treatment of intracardiac thrombi using ultra-slow low-dose thrombolytic therapy: A case report

被引：0

作者：

Pinto, Ricardo Alves ^{[1
]}

Torres, Sofia ^{[1
]}

Formigo, Mariana ^{[2
]}

Sousa, Elsa ^{[2
]}

Coentrao, Luis ^{[2
]}

Neves, Aida ^{[2
]}

Macedo, Filipe ^{[1
]}

Maciel, Maria Julia ^{[1
]}

Oliveira, Teresa ^{[2
]}

机构：

[1] Ctr Hospitalar Univ Sao Joao, Serv Cardiol, Porto, Portugal

[2] Ctr Hospitalar Univ Sao Joao, Serv Med Intensiva, Porto, Portugal

来源：

REVISTA PORTUGUESA DE CARDIOLOGIA | 2023年 / 42卷 / 11期

关键词：

Case report; Mitral valve insufficiency; Pulmonary embolism; Intracardiac thrombi; Thrombolytic therapy; PULMONARY-EMBOLISM; VALVE THROMBOSIS; FIBRINOLYSIS; TRIAL;

D O I：

10.1016/j.repc.2019.09.023

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.(c) 2023 Published by Elsevier Espan similar to a, S.L.U. on behalf of Sociedade Portuguesa de Cardiologia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

引用

页码：925 / 928

页数：4

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