Table 1 Case reports of right atrial thrombi treated with Low dose ultra-slow thrombolytic therapy
Study | age | gender | Comorbidities | Deep vein thrombosis | Pulmonary emboli | Characteristics of thrombi | Size of thrombi | Diagnostic imaging modality | Cause of switching to TT | Prior management of thrombi | Thrombolytic regimen | Duration of infusion | Complete resolution of thrombi | complications |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Yilmaztepe et al | 72 | F | HTN | No | Yes | right atrial mobile mass moving with the tricuspid valve and dilated right ventricle | N/A | TTE | 3th day post major surgery (high risk of bleeding) | None | IV 25 mg of rt-PA for 24 h, without bolus | 18 h | Yes | Minor bleeding from surgery site |
Alves Pinto et al | 57 | M | Mitral regurgitation, right ventricle dysfunction | Yes | Yes | two large mobile right atrial thrombi | 2.4 × 1.5 cm and 3.6 × 3.7 cm | TTE | Refractory to anticoagulant therapy | Unfractionated heparin | IV 24 mg of alteplase for 24 h (1 mg per hour), without bolus | 48 h | Yes | None |
“This report” | 37 | F | COVID-19 | No | Yes | Free-floating right atrial thrombi with protrusion from tricuspid valve to right ventricle | 3.2 × 1.67 cm | TTE, TEE | Refractory to anticoagulant therapy, episodes of gross hematuria | Heparin | IV 24 mg of alteplase in 24 h (1 mg per hour), without bolus | 72 h | Yes | None |