Right heart thrombus in infants and children

Abstract

The echocardiographic features and management of 10 children with right heart thrombus (RHT) are presented. The patients' ages ranged from 2 weeks to 12 years. Three patients were less than 3 weeks old. The echocardiographic diagnosis was confirmed in five patients by surgery or autopsy. The thrombus was detected in the right atrium (five patients), in the right ventricle (three), on the tricuspid valve or within the inferior vena cava, the superior vena cava, or its extension following Senning's operation for transposition of great arteries (TGA). Seven patients had structural heart disease: TGA in four, tricuspid atresia in three. In two of three patients with anatomically normal heart, the thrombus occurred as a complication of a ventriculoatrial and a lymphovenous shunt system. The third patient had no predisposing factor. Five patients were treated with anticoagulants or platelet anti-aggregating agents and four by surgery. Seven patients survived and were followed by echocardiography.

Neonatal and childhood right atrial thrombosis: recognition and a risk-stratified treatment approach

“…Figure 2 [2] Case report 1 Road traffic accident victim on TPN Korones et al [13] Prospective cohort 13 Cancer Marsh et al [14] Prospective 1 Prematurity, bowel perforation on TPN Bilginer et al [15] Case report 1 Renal transplant Torres-Validvesso et al [16] Case report 1 Prematurity Giuffrè et al [17] Case report 2 Prematurity Giannoulia-Karadana et al [18] Case report 2 Wilms tumor Dollery et al [19] Retrospective 5 Gut failure on TPN Asante-Korang et al [20] Case report 1 Tricuspid atresis, post-Fontan procedure Ross et al [21] Retrospective 16 Prematurity and cancer Sharrat et al [22] Case reports 1 Post-Fontan procedure Ozimek et al [23] Case report 1 Non-Hodgkins lymphoma De Schepper et al [24] Case reports 2 Prematurity, on TPN Hollingsed et al [25] Case report 1 Sickle cell anemia, fungal septicemia Riggs et al [26] Case reports 4 Prematurity, TPN, Wilms tumor Ká dá r et al [27] Case report 6 Postcardiac surgery Delaplane et al [28] Case report 1 Prematurity, on TPN Marsh et al [29] Case reports 2 Prematurity, septicemia Mahony et al [30] Case reports 2 Gastroschisis, TPN, and liver tumor Graham and Gumbiner [31] Case report 1 Prematurity, gastroschisis Sadiq et al [32] Case series 10 Prematurity and TPN Cesaro et al [33] Case report 1 Non-Hodgkins lymphoma Kingdon et al [34] Case reports 2 Renal failure on dialysis Paut et al [35] Case report 1 Trauma on TPN Moukarzel et al [36] Retrospective 6 All on TPN Teitelbaum et al [37] Case report 1 Failure to thrive, vomiting, on TPN RAT, right atrial thrombosis; TPN, total parenteral nutrition. …”

A huge intracardiac thrombus developed in the presence of antithrombin III deficiency in a patient with end-stage renal failure

“…In addition to patients with thrombophilia, right heart thrombus can also occur in patients with endocarditis, polycythemia, congenital heart defects, respiratory distress syndrome, and persistent fetal circulation. [3,4] Anti-thrombin III is one of the most important inhibitors of blood coagulation, and it inactivates thrombin and several serine proteases, including factors IXa, Xa, Xia, and XIIa. In addition, recent reports suggest that antithrombin also plays a role in the inhibition of inflammation in the vascular endothelium.…”

Atrioventricular thrombus in a 14-year-old patient: a case report

“…Most pediatric studies have focused on underlying hematologic abnormalities, such as deficiencies in protein C and Factor V, that could predispose one to have an intracardiac thrombus [9,10]. Right heart thrombus occurs in association with the presence of central venous catheters, vegetations due to endocarditis, polycytaemia, congenital heart defects, respiratory distress syndrome and persistent foetal circulation [11,12]. They have been shown to cause superior vena cava syndrome, occlusion of the tricuspit valve, and valvuler insufficiency with rapidly progressive heart failure.…”