Wang Hui, Zhu Zhiwei, Liu Zhenyu, Yuan Yonghua, Xu Xuan, Liu Liping, Wen Jie, Xia Xiaohui, Zhang Yu, He Jin
Department of Pediatric Cardiology, Children's Medical Center, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China.
Department of Pediatric Orthopedics, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China.
Front Pediatr. 2023 Mar 13;11:1138717. doi: 10.3389/fped.2023.1138717. eCollection 2023.
Acute thrombus in atrial septal defect occluders is a rare complication that requires aggressive, effective, and safe management. Tirofiban, a platelet glycoprotein IIb/IIIa receptor antagonist, is widely used for the management of thromboembolic diseases, such as coronary heart disease and stroke. To date, there is no report using the GPIIb/IIIa receptor antagonist tirofiban for the management of ASD closure-related thrombosis in children.
Herein, we reported a case of a 5-year-old girl with ASD who presented with acute thrombus on the left disc of the occluder device immediately after transcatheter closure of ASD. The thrombus was successfully dissolved 24 h after a combined infusion of heparin and tirofiban, followed by 1 months of aspirin and clopidogrel and 5 months of aspirin alone. No thromboembolism or hemorrhage events occurred during follow-up for more than 2 years.
The continuous infusion of GPIIb/IIIa receptor antagonist tirofiban combined with heparin may have beneficial effects for the management of thrombosis during ASD closure procedure.
房间隔缺损封堵器急性血栓形成是一种罕见的并发症,需要积极、有效且安全的处理。替罗非班是一种血小板糖蛋白IIb/IIIa受体拮抗剂,广泛用于治疗血栓栓塞性疾病,如冠心病和中风。迄今为止,尚无使用糖蛋白IIb/IIIa受体拮抗剂替罗非班治疗儿童房间隔缺损封堵相关血栓形成的报道。
在此,我们报告了一例5岁患有房间隔缺损的女孩,在经导管封堵房间隔缺损后,封堵器左盘立即出现急性血栓。在联合输注肝素和替罗非班24小时后,血栓成功溶解,随后服用1个月的阿司匹林和氯吡格雷,之后单独服用5个月的阿司匹林。在超过2年的随访期间未发生血栓栓塞或出血事件。
持续输注糖蛋白IIb/IIIa受体拮抗剂替罗非班联合肝素可能对房间隔缺损封堵术期间的血栓形成处理具有有益作用。