Cardiac thrombi in a patient with protein-C and S deficiencies: a case report
Articles > Article · 2004
Authors: Ertugrul Ercan, Istemihan Tengiz, Cevad Sekuri, Fahri ŞAHİN, Emil Aliyev, Mustafa Akin, Unal Acıkel
Thrombosis Journal, International, Scopus, 2004, vol 2, pp 2-2
Summary
We report a case of multiple mobile intra-cardiac thrombi accompanying recurrent pulmonary embolism that has been successfully treated by fibrinolytic therapy. Control transesophageal echocardiographic examination showed that prolonged thrombolytic treatment completely removed the thrombi. Surgical removal of emboli has been validated but cannot be proposed to all patients since it is a high-risk intervention. Fibrinolysis is generally efficient but exposes the patient to risk of migration of the intra-cavity thrombus, with occasionally deleterious evolution. Systemic thrombolytic therapy is usually recommended if (a) it is not contraindicated and (b) the thrombi are demonstrated in more than one cardiac chamber, entailing a higher risk of surgical intervention. However, the infusion rate and duration of thrombolytic therapy are important determinants of successful and uncomplicated lysis. Low dose and long infusion time should be chosen to avoid fragmentation of the thrombus and related complications.