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Ann Thorac Surg 1986;41:630-635
© 1986 The Society of Thoracic Surgeons

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Articles

Treatment of Grafts and Major Vessel Thrombosis with Low-Dose Streptokinase in Children

Department of Cardiovascular and Thoracic Surgery, Department of Radiology and Department of Pediatrics, B.C. Children's Hospital and University of British Columbia, Canada

Accepted for publication September 19, 1985.

^* Address reprint requests to Dr. LeBlanc, B.C. Children's Hospital, 4480 Oak St, Vancouver, BC, V6H 3V4

Low-dose streptokinase infusions have been used in 8 of our patients. Five of these were newborns who had major vessel occlusion. Four babies had extensive aortic thrombosis and hypertension producing congestive heart failure. One baby had caval and renal vein thrombosis and was in renal failure. Two infants with cyanotic heart disease and 1 with arteritis had occluded prosthetic grafts, which were reopened completely. Two grafts were between the subclavian and pulmonary arteries (Blalock-Taussig shunt), and one was between the abdominal aorta and right renal artery. In each patient, the thrombolytic agent was delivered directly to the area of thrombosis by three or four percutaneously inserted French catheters. The dose of streptokinase used was between 50 and 100 U/kg/hr. Therapy lasted for 2 to 11 days. Major bleeding was anticipated, and it occurred in 1 patient.

Low-dose streptokinase infusion is a safe and effective treatment for a variety of thrombotic problems in infants and children.

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