Treatment of Mobile Right Heart Thrombi

Right heart thrombi are detected in approximately 4% of patients with pulmonary embolism. The associated mortality is high, but the optimal strategy remains controversial. We report a case of a large mobile right heart thrombus, complicated by embolism of the right pulmonary artery, which was succes...

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Detalles Bibliográficos
Autores principales: Sakellariou, Xenofon M, Efstathopoulos, Andreas, Stamatis, Konstantinos V, Nikas, Dimitrios N, Kolettis, Theofilos M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SMC Media Srl 2020
Materias:
Articles
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727624/
https://www.ncbi.nlm.nih.gov/pubmed/33313001
http://dx.doi.org/10.12890/2020_001918
Descripción
Sumario:Right heart thrombi are detected in approximately 4% of patients with pulmonary embolism. The associated mortality is high, but the optimal strategy remains controversial. We report a case of a large mobile right heart thrombus, complicated by embolism of the right pulmonary artery, which was successfully treated with half-dose alteplase. We briefly review the literature and discuss the therapeutic options, focusing on the advantages of thrombolysis. LEARNING POINTS: Mobile right heart thrombi require rapid therapeutic choices between surgical thrombectomy and thrombolysis. Half-dose alteplase may be effective, even in the presence of an extensive thrombus burden.

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