Complete Blalock-Taussig shunt obstruction in < 24 hours post-operative period in a neonate treated emergently using transcatheter angioplasty and low dose local recombinant TPA

Catheter Cardiovasc Interv. 2014 May 1;83(6):964-7. doi: 10.1002/ccd.25281. Epub 2013 Nov 21.

Abstract

A 12-day-old infant with pulmonary atresia, intact ventricular septum, and pulmonary blood flow through a ductus arteriosus developed complete shunt obstruction within 12 hr of creation of a modified Blalock-Taussig shunt. Low dose recombinant tissue plasminogen activator was administered locally as two 0.03 mg/kg bolus injections and was followed by balloon angioplasty. This resulted in complete recanalization of the shunt without any hemorrhagic complications.

Keywords: pediatric interventions; thrombosis; total occlusions.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon*
  • Blalock-Taussig Procedure / adverse effects*
  • Combined Modality Therapy
  • Emergencies
  • Fibrinolytic Agents / administration & dosage*
  • Graft Occlusion, Vascular / diagnosis
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / therapy*
  • Heart Defects, Congenital / surgery*
  • Humans
  • Infant
  • Male
  • Recombinant Proteins / administration & dosage
  • Thrombolytic Therapy*
  • Thrombosis / diagnosis
  • Thrombosis / etiology
  • Thrombosis / therapy*
  • Time Factors
  • Tissue Plasminogen Activator / administration & dosage*
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Recombinant Proteins
  • Tissue Plasminogen Activator