Tissue plasminogen activator for neonatal coronary thrombosis presenting with mitral valve regurgitation and impaired ventricular function.

Abstract

OBJECTIVE:

Neonatal coronary thrombosis is a rarely reported disorder, with variable outcomes described. This study assessed the feasibility and safety of an institutional protocol using tissue plasminogen activator (tPA) administration for the treatment of neonatal coronary artery thrombi.

METHODS:

They reviewed the outcome of three neonates with clinical evidence of myocardial infarction secondary to coronary thrombosis. All three underwent the tPA treatment protocol.

RESULTS:

The three described cases presented at 5 hours, 15 hours, and 10 days of life. The patients identified underwent the tPA protocol at least once. There was clinical evidence of improvement in coronary flow, as well as demonstration of increased left ventricular function and decreased mitral regurgitation. No major adverse events occurred.

CONCLUSION:

Thrombolytic therapy with this tPA protocol may be safe and effective in treating neonates with coronary thrombosis.

• Authors: Delaram Molkara, Jose A Silva Sepulveda, Thomas Do, Christopher Davis, Gregory P Goldstein, John W Moore, Howaida G El-Said
• Journal: Congenital heart disease (Congenit Heart Dis) Vol. 12 Issue 3 Pg. 270-274 (May 2017) ISSN: 1747-0803 [Electronic] United States
• PMID: 28140523 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: © 2017 Wiley Periodicals, Inc.

Chemical References

• Fibrinolytic Agents
• Tissue Plasminogen Activator

Topics

• Cardiac Catheterization
• Coronary Angiography
• Coronary Thrombosis (complications, diagnosis, drug therapy)
• Dose-Response Relationship, Drug
• Echocardiography
• Electrocardiography
• Female
• Fibrinolytic Agents (administration & dosage)
• Humans
• Infant, Newborn
• Male
• Mitral Valve Insufficiency (diagnosis, etiology, physiopathology)
• Thrombolytic Therapy (methods)
• Tissue Plasminogen Activator (administration & dosage)
• Ventricular Dysfunction, Left (diagnosis, etiology, physiopathology)
• Ventricular Function, Left (physiology)