Acutely blocked Blalock-Taussig shunt following cardiac catheterization: Successful recanalization with intravenous streptokinase

Rajani, Rajesh; Dalvi, Bharat; Kulkarni, Hema; Kale, Purushottam A.

doi:10.1016/0002-8703(90)90149-r

Cited by 23 publications

(12 citation statements)

References 9 publications

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“…When a shunt is acutely occluded, a quick and effective emergency therapeutic approach is required. If revascularization cannot be achieved rapidly with intravenous heparin or streptokinase, 8 then balloon dilation may be attempted as an alternative to further surgery. 0 We were able to perform this within three weeks of the shunt operation without complications.…”

Section: Discussionmentioning

confidence: 99%

Balloon dilation recanalization of completely occluded modified Blalock-Taussig shunt

Galal

Qureshi

1994

Cardiol Young

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SummaryA two-month-old boy, with complex pulmonary atresia, became increasingly cyanosed 10 days after a modified 5 mm right Blalock-Taussig shunt. There was no shunt flow on auscultation or Doppler echocardiography. Despite anticoagulation with heparin, the shunt remained occluded. After demonstration of the occluded shunt at angiography, a guide wire was easily passed through the occlusion and into the pulmonary artery. Balloon dilation was then successfully accomplished with a 6 mm diameter angioplasty balloon resulting in a patent shunt. The shunt was still widely patent at cardiac catheterization six months later.

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Section: Discussionmentioning

confidence: 99%

Balloon dilation recanalization of completely occluded modified Blalock-Taussig shunt

Galal

Qureshi

1994

Cardiol Young

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“…68,69 Acute BT shunt occlusion may be treated with thrombolytic therapy, stenting, or repeat surgery. 67,70 Fontan Procedure. The Fontan principle is diversion of systemic venous return to the pulmonary arteries in univentricular hearts, and although the original procedure has been modified, the principle remains the same.…”

Section: Congenital Heart Diseasementioning

confidence: 99%

Arterial Thromboembolism in the Pediatric Population

2003

Semin Thromb Hemost

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The most common cause of arterial thromboembolism in the pediatric population is secondary to arterial catheterization. Non-catheter-related arterial thromboembolism is rare. The frequency of this complication has paralleled the advances in pediatric tertiary care that has lead to increasing numbers of children surviving life-threatening primary illnesses. Previously, these events were very rare and children were managed according to adult protocols. It is now known that the pathophysiology of thrombosis in children differs from that of adults and indeed is different for that of various age groups within the pediatric population, therefore requiring a unique diagnostic and therapeutic approach. This review highlights the available published data to support an evidence-based approach to the complication of arterial thromboembolism in the pediatric population, and underscores the urgent need for further randomized controlled trials.

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“…Local thrombolytic therapy with t-PA and streptokinase have been used successfully in some children. 71,79 Angioplasty, balloon dilation, stent implantation, 68,80 and repeat surgery 64,66 are other therapeutic options. Whatever the primary therapy, children with BT shunt thrombosis usually require subsequent anticoagulation therapy.…”

Section: Blalock-taussig Shuntsmentioning

confidence: 99%

Thrombosis in Pediatric Cardiac Patients

Monagle

2003

Semin Thromb Hemost

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Cardiac disease and thrombosis are intimately related in adults, but primary myocardial infarction in children is rare. Homozygous familial hyperlipidemia occurs in approximately 1 million children, and causes severe coronary artery disease during childhood. Kawasaki's disease is an acquired inflammatory disorder, which, if untreated, leads to coronary artery aneurysms and subsequent myocardial infarction. The current understanding of the pathophysiology and management of these conditions is discussed. More commonly, the relationship between cardiac disease in children and thrombosis is that children being treated for congenital structural cardiac disease develop iatrogenic thrombosis, most commonly precipitated by central venous access. The epidemiology of common treatment-induced thrombosis is described, and management guidelines presented. Finally, many cardiac surgical procedures increase the risk of thrombosis, and prophylactic antithrombotic therapy is commonly used. The current evidence for prophylaxis in different clinical situations is presented. Additional study is required in all areas to improve the outcome for children affected by cardiac disease and thrombosis.

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Acutely blocked Blalock-Taussig shunt following cardiac catheterization: Successful recanalization with intravenous streptokinase

Cited by 23 publications

References 9 publications

Balloon dilation recanalization of completely occluded modified Blalock-Taussig shunt

Balloon dilation recanalization of completely occluded modified Blalock-Taussig shunt

Arterial Thromboembolism in the Pediatric Population

Thrombosis in Pediatric Cardiac Patients

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