A Single-Center Experience with Intracardiac Thrombosis in Children with Dilated Cardiomyopathy

Choi, Soo-Han; Jeong, Sang Jin; Yang, Ji-Hyuk; Kang, I-Seok; Jun, Tae-Gook; Lee, Heung-Jae; Huh, June

doi:10.1007/s00246-009-9602-3

Cited by 28 publications

(30 citation statements)

References 29 publications

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“…[261][262][263][264][265][266][267][268][269][270][271][272][273] There are no specifi c guidelines for the use of thrombectomy in children, but there is general consensus that the TE recurrence rate and risk of long-term vas-tive of whether the infant received no therapy, UFH, or LMWH, with ‫ف‬ 70% of affected kidneys having irreversible renal atrophy. 279 Approximately 20% of children had hypertension on long-term follow-up, and 3% of children developed chronic renal failure.…”

Section: Surgical Therapymentioning

confidence: 99%

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Antithrombotic Therapy in Neonates and Children

Monagle

Chan

Goldenberg

et al. 2012

Chest

1,236

575

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Section: Surgical Therapymentioning

confidence: 99%

“…Thrombosis remains a signifi cant cause of morbidity and mortality. 262,575,576 In a cross-sectional study of children awaiting cardiac transplant, 31% had acute PE confi rmed by ventilation/perfusion scan or angiography. 577 A series of 66 patients with dilated cardiomyopathy reported a prevalence of thrombosis of 14%.…”

Section: Dilated Cardiomyopathymentioning

confidence: 99%

Antithrombotic Therapy in Neonates and Children

Monagle

Chan

Goldenberg

et al. 2012

Chest

1,236

575

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“…[280][281][282][283] There are no similar prospective data available in children with systolic ventricular dysfunction, and the true risk of thromboembolism is unknown, regardless of NMD status. [284][285][286][287][288][289][290][291] It is well established that thrombosis prevention is indicated in adults with AF/atrial flutter in the absence of ventricular dysfunction, and extremely detailed riskbased guidelines for anticoagulation in AF/atrial flutter exist 205 ; however, data in children and those with NMDs are lacking. A study of arrhythmias in NMD described AF/atrial flutter in 139 patients with laminopathy (lamin A/C), MFM, DM1 and DM2, DMD, BMD, EDMD, LGMD, or facioscapulohumeral muscular dystrophy.…”

Section: Anticoagulationmentioning

confidence: 99%

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Feingold¹,

Mahle²,

Auerbach³

et al. 2017

Circulation

211

195

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For many neuromuscular diseases (NMDs), cardiac disease represents a major cause of morbidity and mortality. The management of cardiac disease in NMDs is made challenging by the broad clinical heterogeneity that exists among many NMDs and by limited knowledge about disease-specific cardiovascular pathogenesis and course-modifying interventions. The overlay of compromise in peripheral muscle function and other organ systems, such as the lungs, also makes the simple application of endorsed adult or pediatric heart failure guidelines to the NMD population problematic. In this statement, we provide background on several NMDs in which there is cardiac involvement, highlighting unique features of NMD-associated myocardial disease that require clinicians to tailor their approach to prevention and treatment of heart failure. Undoubtedly, further investigations are required to best inform future guidelines on NMD-specific cardiovascular health risks, treatments, and outcomes. N euromuscular diseases (NMDs) encompass a broad spectrum of diagnoses with overlapping but distinct phenotypes. Common to many NMDs is cardiac involvement. Although the past 3 decades have seen marked advances in our understanding of many NMDs, significant gaps in knowledge remain on how best to approach cardiac care in these patients. For example, survival in Duchenne muscular dystrophy (DMD) has been extended through the use of glucocorticoid use and respiratory support, yet cardiac complications remain a significant cause of morbidity and mortality.1-3 To achieve further gains in care, we will need to improve our understanding of the pathophysiologies driving cardiac involvement in NMDs and advance treatments aimed at preventing the progression of heart failure (HF) and sudden death in NMDs. The recently published findings of an expert working group on cardiac involvement in DMD, which outlined key gaps in knowledge and made specific recommendations aimed at improving diagnosis and management, are a step toward this goal. 4 In this statement, we include a comprehensive overview of the major categories of NMDs with cardiac involvement. For each, a brief background of the gene defect(s), common clinical manifestations (particularly cardiac findings), and current therapies is summarized. Gaps in knowledge are highlighted, and where possible, clinical treatment suggestions are made by the expert writing group appointed by the American Heart Association to review the available literature. Selection of the writing group was performed in accordance with the American Heart Association's conflict-of-interest management policy. Participants volunteered to write sections relevant to their expertise and experience. CLINICAL STATEMENTS AND GUIDELINESconducted a general search of the literature, restricted to human subjects research published between 1980 and 2016. Drafts of each section were written and sent to the chair of the writing group for incorporation into a single document, which was then edited. The edited document was discussed electron...

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“…Thrombus can be treated with warfarin, [12,13] but dabigatran can be considered an alternative to warfarin therapy. Five previous cases of dabigatran administration resulting in resolution of thrombus have been reported [7,[14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Resolution of Left Ventricular Thrombus after Dabigatran Therapy in Two Patients with Old Anteroseptal Myocardial Infarction

Yamamoto¹

2015

Cardiol Pharmacol

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Dabigatran has been used recently as an alternative to warfarin therapy for the prevention of thromboembolism in patients with myocardial infarction or atrial fibrillation, but treatment of established intracardiac thrombus with dabigatran has seldom been reported. We report two patients with left ventricular (LV) thrombus who were successfully treated with dabigatran. The first patient was a 52-year-old man with no clear symptoms who was referred for investigation of abnormal electrocardiography findings, and the second patient was a 51-year-old man with recent onset of heart failure and a history of chest pain 1 month previously. Both patients were diagnosed with old anteroseptal myocardial infarction after echocardiography showed abnormal LV wall motion and LV thrombus. The thrombus was thought to be chronic in the first patient, and to have formed within the preceding month in the second patient. After treatment with dabigatran 220 mg/day and antiplatelet drugs, repeat echocardiography showed resolution of the thrombus after 6 weeks and 2 weeks, respectively. These cases illustrate that dabigatran 220 mg/ day may be useful for the treatment of established LV thrombus.

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A Single-Center Experience with Intracardiac Thrombosis in Children with Dilated Cardiomyopathy

Cited by 28 publications

References 29 publications

Antithrombotic Therapy in Neonates and Children

Antithrombotic Therapy in Neonates and Children

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Resolution of Left Ventricular Thrombus after Dabigatran Therapy in Two Patients with Old Anteroseptal Myocardial Infarction

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