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Catheter-directed thrombolysis for in situ pulmonary artery thrombosis in children

Evyatar Hubara1, Sharon Borik2, Gili Kenet3

  • 1Department of Pediatric Cardiac Critical Care Medicine, Sheba Medical Center, The Edmond and Lily Safra Children's Hospital, Tel Hashomer, Israel.

Annals of Pediatric Cardiology
|June 9, 2021
PubMed

Insights

In situ pulmonary artery thrombosis (ISPAT) is a rare condition. This case study shows successful treatment of ISPAT in a baby with hypoplastic left heart syndrome using catheter-directed thrombolysis and anticoagulation.

Area of Science:

  • Cardiovascular Medicine
  • Pediatric Cardiology
  • Interventional Cardiology

Background:

  • In situ pulmonary artery thrombosis (ISPAT) is a localized form of pulmonary embolism.
  • Hypoplastic left heart syndrome (HLHS) presents complex congenital heart defects.
  • The Glenn procedure is a palliative surgery for HLHS, carrying specific risks.

Observation:

  • A neonate with HLHS developed ISPAT post-Glenn surgery.
  • The thrombosis was identified within the pulmonary arteries.
  • This complication occurred despite the palliative surgical intervention.

Findings:

  • Catheter-directed thrombolysis was performed to dissolve the thrombus.
  • Systemic anticoagulation was initiated following the procedure.
  • The treatment resulted in excellent clinical outcomes for the patient.

Implications:

  • This case highlights ISPAT as a potential complication after the Glenn procedure in HLHS patients.
  • Catheter-directed thrombolysis offers a viable and effective treatment option for ISPAT.
  • Early recognition and intervention are crucial for managing ISPAT in pediatric cardiac surgery patients.

Keywords:
Cardiac surgerycatheter-directed thrombolysisin situ pulmonary artery thrombosispulmonary embolism

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