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Ann Thorac Surg 1984;38:637-639
© 1984 The Society of Thoracic Surgeons

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Articles

Thrombolytic Therapy for Superior Vena Caval Thrombosis Following Superior Vena Cava–Pulmonary Artery Anastomosis

Departments of Cardiovascular/Interventional Radiology, Cardiothoracic Surgery, and Cardiology, University of California, Los Angeles, Center for the Health Sciences, Los Angeles, CA

Accepted for publication February 20, 1984.

^* Address reprint requests to Dr. Dajee, Division of Cardiothoracic Surgery, UCLA Center for the Health Sciences, Los Angeles, CA 90024

Immediate postoperative thrombosis of left superior vena cava–left pulmonary artery anastomosis in a modified Fontan procedure for single ventricle and pulmonary artery stenosis is described. Before thrombolytic therapy with streptokinase is initiated, confirmation of thrombosis by venography is mandatory to lessen the risk of cardiac tamponade or hemothorax. By this technique major surgical intervention is avoided, but close attention to the dose of streptokinase and the coagulation profile is essential. Measures to be taken if bleeding occurs with streptokinase therapy are described.

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