Successful Thrombolytic Therapy of Pulmonary Embolism Associated with Urosepsis in an Infant

Pugh, Keith; Jureidini, Saadeh B.; Ream, Robert S.; Rao, P. Syamasundar; Dossier, J.

doi:10.1007/s00246-001-0019-x

Cited by 4 publications

(3 citation statements)

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“…Along the way, the art and science of interventional pediatric cardiology were presented, as applicable to each chapter of the book. cardiac murmurs in children [143], delayed presentation of anomalous circumflex coronary artery arising from pulmonary artery following prior surgical repair of aortopulmonary window in infancy [144], chest pain in children [145], congenital coronary artery anomalies [146], successful thrombolytic therapy of pulmonary embolism seen in association with urosepsis in an infant [147], current perspectives on Kawasaki disease [148], an approach to the diagnosis of cyanotic neonate for the primary care provider [111], principles of management of the neonate with CHD [110,140], cardiac emergencies in pediatric practice [149][150][151][152], development of supravalvar pulmonary artery stenosis following a Nuss procedure (Figure 21 and Figure 22) [153], consensus on timing of intervention for common congenital heart diseases [72,154], a review of childhood hypertension [155], prevention of sudden death in athletes [156] and state of the art management of CHDs [73,157] was presented. Developments such as early detection of the neonates with serious heart disease and their rapid transport to tertiary care centers, availability of highly sensitive noninvasive diagnostic tools, advances in neonatal care and anesthesia, progress in percutaneous interventional procedures and extension of complicated surgical procedures to the neonate and infant have advanced to such a degree that almost all congenital cardiac defects can be diagnosed and "corrected".…”

Section: Discussionmentioning

confidence: 99%

Evolution of Pediatric Cardiology over the Last 50 Years - Part IV

Syamasundar¹

2021

Int J Clin Cardiol

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Check for updatesphysiologically advantageous VSDs occurs as often as in isolated VSDs. The mechanisms of closure is also similar to that seen in isolated VSDs. VSD closures were documented to take place in utero, during infancy, childhood, and adolescence and continue through adulthood. It was concluded that there is a great natural tendency for spontaneous closure of VSDs whether it be an isolated defect or is a component of a complex heart defect [10][11][12][13][14][15][16].Spontaneous closure of VSD in children with tricuspid atresia and normally related great arteries (Type I) produces decreased pulmonary blood flow and requires surgical intervention earlier than otherwise needed. We recommended that a Blalock-Taussig (BT) shunt (preferably on the left side) is carried out instead of a Glenn anastomosis (the concept of bidirectional Glenn has not yet been crystallized as of that time) because VSD closure following Glenn will result in no blood flow into the left pulmonary artery (Figure 3). If further palliation is required prior to Fontan procedure, a BT shunt on the right side, Glenn anastomosis, or enlargement of the VSD may be entertained. In subjects with tricuspid atresia and transposition of the great arteries (Type II), VSD closure produces left ventricular outflow obstruction. Therefore, it is highly important that the size of the VSD is appraised before planning for Fontan. If the VSD is small, enlarging the VSD surgically or bypassing the VSD and the right ventricle via a pulmonary artery-to-ascending aorta anastomosis (Damus-Kaye-Stansel) or by a left ventricle-descending aorta conduit (Figure 4) should be considered [10][11][12][13][14]. In addition to tricuspid atresia and double outlet right

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Section: Discussionmentioning

confidence: 99%

Evolution of Pediatric Cardiology over the Last 50 Years - Part IV

Syamasundar¹

2021

Int J Clin Cardiol

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“…However, this is often considered as a last resort given its high operative mortality rate of 30% to 60%. 5,8 In our case, a multidisciplinary discussion was held to determine the best antithrombotic therapy in addition to standard anticoagulation therapy. Given the patient's single ventricle physiology and the need for low pulmonary vascular resistance to be considered a good candidate for the second and third stages of operative palliation, it was imperative that the perfusion to the distal right pulmonary artery and distal left pulmonary artery be reestablished.…”

Section: Discussionmentioning

confidence: 99%

“…However, this is often considered as a last resort given its high operative mortality rate of 30% to 60%. 5,8…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Embolism in a Neonate Following Modified Norwood Procedure With Sano Shunt

Schlueter

Wilhelm

Anagnostopoulos

et al. 2019

World J Pediatr Congenit Heart Surg

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Pulmonary embolism is a rare but potentially fatal complication in neonates with congenital heart disease. The authors report a case of pulmonary embolism in the immediate postoperative period following modified Norwood procedure with Sano shunt. In addition, this report discusses the initial evaluation and available anticoagulation options to treat pulmonary embolism in children with congenital heart disease.

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Outcome of Cardiac Thrombi in Infants

et al. 2007

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Use of central lines in the neonatal intensive care unit (NICU) has led to the formation of intracardiac thrombi. A paucity of data exists on the management of neonatal cardiac thrombi, with the few reported cases focusing on outcomes following thrombolytic therapy. This study was undertaken to evaluate the outcome of cardiac thrombi in neonates who do not receive thrombolytic therapy. Nineteen patients younger than 3 months of age diagnosed with cardiac thrombi were included. All 19 patients had a central line. Management consisted of a combination of antibiotics and low-molecular-weight heparin (n = 16) or surgical removal (n = 2). In one case, no treatment was instituted. One patient was lost to follow-up after partial resolution of the thrombus. Complete thrombus resolution occurred in 18 patients, 9 with negative blood cultures and 9 with positive blood cultures. It took longer for resolution of thrombi associated with positive blood cultures than for sterile thrombi. No patient had evidence of thrombus embolization. From these data we concluded that the natural history of cardiac thrombi is resolution. Infected thrombi require more prolonged therapy. Surgery is seldom required and thrombolytics are not usually necessary for clot resolution.

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Successful Thrombolytic Therapy of Pulmonary Embolism Associated with Urosepsis in an Infant

Cited by 4 publications

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Evolution of Pediatric Cardiology over the Last 50 Years - Part IV

Evolution of Pediatric Cardiology over the Last 50 Years - Part IV

Pulmonary Embolism in a Neonate Following Modified Norwood Procedure With Sano Shunt

Outcome of Cardiac Thrombi in Infants

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