Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Mar 13:11:1138717.
doi: 10.3389/fped.2023.1138717. eCollection 2023.

Case report: Early thrombosis in left atrial during transcatheter closure of ASD in a child with favorable outcome after use of GPIIb/IIIa receptor antagonist and heparin

Hui Wang  1 , Zhiwei Zhu  1 , Zhenyu Liu  1 , Yonghua Yuan  1 , Xuan Xu  1 , Liping Liu  1 , Jie Wen  2 , Xiaohui Xia  3 , Yu Zhang  4 , Jin He  4
Affiliations
Case Reports

Case report: Early thrombosis in left atrial during transcatheter closure of ASD in a child with favorable outcome after use of GPIIb/IIIa receptor antagonist and heparin

Hui Wang et al. Front Pediatr. .

Abstract

Background: 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.

Case presentation: 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.

Conclusion: 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.

Keywords: ASD; case report; catheterization; children; complications; thrombosis; tirofiban.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Floating thrombus in the edge of the left atrial disc of the occluder (white arrow).
Figure 2
Figure 2
Thrombus disappeared over 90% 24 h after tirofiban and heparin infusion (white arrow).
Figure 3
Figure 3
Transthoracic echocardiography at 1-month post-procedure showed that the thrombus was completely absorbed.
See this image and copyright information in PMC

References

    1. Liu Y, Chen S, Zühlke L, Black GC, Choy MK, Li N, et al. Global birth prevalence of congenital heart defects 1970–2017: updated systematic review and meta-analysis of 260 studies. Int J Epidemiol. (2019) 48(2):455–63. 10.1093/ije/dyz009 - DOI - PMC - PubMed
    1. Bouma BJ, Mulder BJ. Changing landscape of congenital heart disease. Circ Res. (2017) 120(6):908–22. 10.1161/CIRCRESAHA.116.309302 - DOI - PubMed
    1. Mills NL, King TD. Nonoperative closure of left-to-right shunts. J Thorac Cardiovasc Surg. (1976) 72(3):371–8. 10.1016/S0022-5223(19)40065-2 - DOI - PubMed
    1. Fischer G, Stieh J, Uebing A, Hoffmann U, Morf G, Kramer HH. Experience with transcatheter closure of secundum atrial septal defects using the amplatzer septal occluder: a single centre study in 236 consecutive patients. Heart. (2003) 89(2):199–204. 10.1136/heart.89.2.199 - DOI - PMC - PubMed
    1. Fiarresga A, De Sousa L, Martins JD, Ramos R, Paramés F, Freitas I, et al. Percutaneous closure of atrial septal defects: a decade of experience at a reference center. Rev Port Cardiol. (2010) 29(5):767–80. PMID: - PubMed

Publication types

LinkOut - more resources