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(Chest. 2001;120:681-683.)
© 2001 American College of Chest Physicians

Lysis of a Left Ventricular Thrombus With Recombinant Tissue Plasminogen Activator*

Benjamin T. Rester, MD; James L. Warnock, MD; Praful B. Patel, MD; Michael R. McMullan, MD; Thomas N. Skelton, MD and Nancy A. Collop, MD, FCCP

* From the Department of Internal Medicine, Divisions of Cardiology and Pulmonology/Critical Care, University of Mississippi Medical Center, Jackson, MS.

Correspondence to: Nancy A. Collop, MD, FCCP, Professor of Medicine, Pulmonary and Critical Care Medicine, University of Mississippi Medical Center, 2500 North State St, Jackson, MS 39216-4505; e-mail: ncollop{at}aol.com

A 23-year-old woman with peripartum cardiomyopathy presented with a 2.1 x 2.5-cm pedunculated, mobile, left ventricular thrombus and evidence of systemic embolization. Due to the patient’s poor left ventricular function, thrombectomy was not a viable option. Treatment with high-dose IV heparin was initially utilized but was unsuccessful as the thrombus appeared to enlarge on echocardiography. An accelerated weight-adjusted dose of recombinant tissue plasminogen activator (rt-PA) successfully lysed the thrombus without evidence of embolization. Although rt-PA has been used for primary lysis of high-risk ventricular thrombi, this is the first documentation of successful lysis of a left ventricular thrombus in a patient with peripartum cardiomyopathy.

Key Words: adult • cardiomyopathy • echocardiography • thrombolysis • thrombus




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M. Rothenburger, M. J. Wilhelm, D. Hammel, C. Schmidt, T. D. T. Tjan, D. Bocker, H. H. Scheld, and C. Schmid
Treatment of Thrombus Formation Associated With the MicroMed DeBakey VAD Using Recombinant Tissue Plasminogen Activator
Circulation, September 24, 2002; 106(12_suppl_1): I-189 - I-192.
[Abstract] [Full Text] [PDF]


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