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[Successful lysis of a mobile left ventricular thrombus by slow infusion of low-dose tissue plasminogen activator]

Yılmaz Güneş1, Yemlihan Ceylan, Mustafa Tuncer

  • 1Yüzüncü Yıl Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Van, Turkey. yilmazleman@yahoo.com

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|January 6, 2011
PubMed

Insights

Low-dose thrombolytic therapy using recombinant tissue-type plasminogen activator (rt-PA) successfully dissolved a left ventricular thrombus in a patient unsuitable for surgery. This approach offers a potential alternative for managing left ventricular thrombi.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pharmacology

Background:

  • Management of intracardiac mural thrombi lacks a clear consensus.
  • Left ventricular thrombi can lead to severe complications such as systemic embolism.

Observation:

  • A 59-year-old male presented with symptoms indicative of peripheral artery occlusion.
  • Echocardiography revealed severe left ventricular systolic dysfunction and a mobile left ventricular apical thrombus.
  • Surgical intervention was deemed high-risk for the patient.

Findings:

  • Slow infusion of low-dose recombinant tissue-type plasminogen activator (rt-PA) was administered.
  • Serial echocardiograms demonstrated a significant reduction in thrombus size during rt-PA infusion.
  • Complete thrombus lysis was achieved within 24 hours of rt-PA therapy.

Implications:

  • Low-dose, slow-infusion rt-PA may represent a viable therapeutic option for left ventricular thrombi.
  • This strategy could be particularly beneficial for patients with high surgical risks.
  • Further research is warranted to establish the safety and efficacy of this treatment modality.

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