Thrombolysis of mobile right atrial thrombi following severe pulmonary embolism

Thrombolysis may favorably affect the clinical outcome of mobile right atrial thrombus following pulmonary embolism (PE). We report the case of three patients with mobile right atrial thrombus following PE, in whom fibrinolysis was performed. Atrial mass disappeared on the control echocardiogram, but control ventilation perfusion scan showed new perfusion defects in all patients. Thrombolysis seems successful for the treatment of patients with mobile right atrial thrombus following PE; however, recurrent PE may be induced by fibrinolysis. This may affect the benefit of such therapy and should be taken into account when using this therapeutic treatment.

[1]  E. Ferrari,et al.  Association between thrombolytic treatment and the prognosis of hemodynamically stable patients with major pulmonary embolism. , 1998, Circulation.

[2]  M. Olschewski,et al.  Association between thrombolytic treatment and the prognosis of hemodynamically stable patients with major pulmonary embolism: results of a multicenter registry. , 1997, Circulation.

[3]  F. Casazza,et al.  Prevalence and prognostic significance of right-sided cardiac mobile thrombi in acute massive pulmonary embolism. , 1997, The American journal of cardiology.

[4]  M. Delgado,et al.  Thrombus in right atrium in two infants successfully treated with tissue plasminogen activator. , 1997, Pediatric emergency care.

[5]  G. Guiraudon,et al.  Management of Mobile Right Atrial Thrombi: A Therapeutic Dilemma , 1996, Journal of cardiac surgery.

[6]  U. Janssens,et al.  Successful lysls of mobile right heart and pulmonary artery thrombi, diagnosis and monitoring by transoesophageal echocardlography , 1996 .

[7]  U. Janssens,et al.  Successful lysis of mobile right heart and pulmonary artery thrombi, diagnosis and monitoring by transoesophageal echocardiography. , 1996, European heart journal.

[8]  G. Raskob,et al.  Risks for Major Bleeding from Thrombolytic Therapy in Patients with Acute Pulmonary Embolism: Consideration of Noninvasive Management , 1994, Annals of Internal Medicine.

[9]  M. Haissaguerre,et al.  Life-threatening pulmonary embolism with right-sided heart thrombus. Rapid recovery with recombinant tissue plasminogen activator. , 1994, Chest.

[10]  Michael J. Zappa,et al.  Value of the ventilation/perfusion scan in acute pulmonary embolism: Results of the prospective investigation of pulmonary embolism diagnosis , 1991 .

[11]  P. Investigators,et al.  Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). , 1990, JAMA.

[12]  G. Kronik.  The European Cooperative Study on the clinical significance of right heart thrombi , 1989 .

[13]  Rosalind J Wright,et al.  Efficacy of treatment of patients with echocardiographically detected right-sided heart thrombi: a meta-analysis. , 1989, American heart journal.

[14]  F. Richards,et al.  Right-sided cardiac thrombi and pulmonary embolism. , 1987, The American journal of cardiology.

[15]  Z. Vered,et al.  Review of echocardiographically diagnosed right heart entrapment of pulmonary emboli-in-transit with emphasis on management. , 1987, American heart journal.

[16]  I. Starkey,et al.  Echocardiographic identification of right-sided cardiac intracavitary thromboembolus in massive pulmonary embolism. , 1982, Circulation.