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.

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.

• Authors: Amit Patange, Jennifer Blake, Srinath Gowda
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 83 Issue 6 Pg. 964-7 (May 01 2014) ISSN: 1522-726X [Electronic] United States
• PMID: 24867628 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2013 Wiley Periodicals, Inc.

Chemical References

• Fibrinolytic Agents
• Recombinant Proteins
• Tissue Plasminogen Activator

Topics

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