Recombinant XXXX in the Treatment of Neonates with Intracardiac and Great Vessels @entity715 .

@entity1 @entity715 @entity1456 @entity548
UNASSIGNED: Life-threatening intracardiac and great vessels thrombi are rare in neonates. Recombinant @entity1456 (rTPA) is used in adults to stimulate fibrinolysis and facilitate @entity715 resolution. Its use in neonates, along with heparin, remains controversial because of potential risk of serious @entity548 . We aim to present our experience with the use of thrombolytic agents in seven neonates and young @entity1 . In a retrospective study, over a period of 6  years, the medical records of neonates and young @entity1 , who were diagnosed with intracardiac and great vessels thrombi, were reviewed. The following factors were collected: demographic data, primary diagnosis, @entity715 site, risk factors, method of diagnosis, thrombolytic and/or anticoagulation agent, route, dose and duration of treatment, complications, and outcome. Six neonates and one 45-day-old @entity1 were analyzed. Age ranged from 5 to 45  days (median age 12  days), and median weight was 2.9  kg (range 0.9-3.8  kg). The thrombi were diagnosed by echocardiography in five and by angiography in two cases. All @entity1 had life-threatening thrombi; four were treated with rTPA (0.5  mg  kg(-1)  h(-1)) and heparin infusions with complete dissolution of the thrombi, within a median time of 60  h (6-72  h), and without complications. The remaining three @entity1 (two who were premature, at 28 and 34  weeks of gestation, and the third who had a deranged coagulation profile) were treated with unfractionated heparin due to fear of @entity548 . The thrombi dissolved in the premature babies (within 2  weeks and 3  months, respectively) but embolized and resulted in the death of the third @entity1 after 2  weeks of treatment. The current case series confirmed the effectiveness and safety of intravenous rTPA infusion, at the dosages used, in neonates and young @entity1 with life-threatening thrombi.
