Successful treatment of infective endocarditis with recombinant tissue plasminogen activator

Aviva Levitas, Nili Zucker, Eli Zalzstein, Shaul Sofer, Joseph Kapelushnik, Kyla A. Marks

    Research output: Contribution to journalArticlepeer-review

    22 Scopus citations


    Objectives: In a prospective study, we examined the effect of treatment with recombinant tissue plasminogen activator (r-TPA) on survival and morbidity in a series of high-risk children with infectious endocarditis (IE) after prolonged treatment with indwelling catheters. We hypothesized that r-TPA is an adjunctive therapy for dissolution of infected thrombi in drug-resistant IE. Study design: In the prospective 3-year study (1998-2001), we identified high-risk children with chronic illness and prolonged treatment with indwelling catheters who developed IE and overwhelming sepsis. Patients were allocated to receive r-TPA after persistent and enlarging intracardiac vegetations and failure to respond to conventional medical management. Complications associated with treatment, survival, and cardiac morbidity were observed. Results: Seven infants were treated prospectively with r-TPA. All infants responded promptly to treatment, with resolution of the intracardiac vegetations within 3 to 4 days of commencement and without any adverse complications. All patients survived without long-term cardiac morbidity. Conclusion: Recombinant tissue plasminogen activator may offer a safe alternative to surgical intervention in the high-risk infant with IE.

    Original languageEnglish
    Pages (from-to)649-652
    Number of pages4
    JournalJournal of Pediatrics
    Issue number5
    StatePublished - 1 Jan 2003

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health


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