Thrombus in right atrium in two infants successfully treated with tissue plasminogen activator.

The widespread use of central venous catheters in children has increased thrombotic complications that warrant thrombolytic therapy. We report the cases of two infants, aged four and two months, with a mobile thrombus in the right atrium treated with recombinant tissue-plasminogen-activator (rt-PA) infused by a central venous catheter. Clot dissolution was obtained in both patients in eight and 44 hours, respectively. One patient presented mild respiratory distress probably from a pulmonary microembolism that disappeared in a few days. Both had minor bleeding from venipuncture sites, but no major hemorrhage.