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Half-dose thrombolytic therapy in patients with right heart thrombi. | LitMetric

AI Article Synopsis

  • Management of floating right heart thrombi (FRHT) in patients with acute pulmonary emboli is debated, with new data suggesting systemic thrombolytic therapy may be more effective and have better survival rates than surgery.
  • This case series details the outcomes of five patients who received "half-dose" thrombolytic therapy (50 mg of alteplase) for FRHT, resulting in complete resolution of thrombi and improved heart function.
  • There were no bleeding complications noted, indicating that half-dose therapy could be a safe and effective option for patients at high risk for bleeding, warranting further research with larger study populations.

Article Abstract

The management of floating right heart thrombi (FRHT) in patients with acute pulmonary emboli is controversial. Several recent case series have revealed similar efficacy and better survival rates with systemic thrombolytic therapy than with surgery. In this case series, we present our experience with the efficacy of “half-dose” or “safe-dose” thrombolytic therapy in the resolution of FRHT. Five patients who were admitted with confirmed acute pulmonary emboli and FRHT were included in the present report. Half-dose thrombolytic therapy (50 mg of alteplase) was administered to the patients. Follow-up echocardiography revealed complete resolution of the FRHT and considerable improvement in the right heart function. No bleeding events were recorded. Our small case series shows the efficacy and safety of half-dose thrombolytic therapy in FRHT resolution in a group of patients with high bleeding risk. Our findings should be tested in larger populations.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683889PMC
http://dx.doi.org/10.1177/0300060519850399DOI Listing

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