Medical and Invasive Management of Cardiac Thrombosis in Children with Congenital and Acquired Heart Disease

• Published in: Current treatment options in pediatrics Vol. 6; no. 4; pp. 283 - 298
• Main Authors: Kim, John S., Loi, Michele M., Stone, Matthew L., VanderPluym, Christina J.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2020; Springer Nature B.V
• Subjects: Anticoagulants; Cardiology/CT Surgery (K Gist; Cardiovascular disease; Critical Care Medicine; Disease prevention; Family Medicine; FDA approval; General Practice; Intensive; Maternal and Child Health; Medicine; Medicine & Public Health; Pediatrics; Section Editor; Thromboembolism; Topical Collection on Cardiology/CT Surgery; Direct thrombin inhibitors; Pediatric cardiology; Anticoagulation; Intracardiac thrombosis; Thrombolysis; Venous thromboembolism
• ISSN: 2198-6088; 2198-6088
• DOI: 10.1007/s40746-020-00214-3

Purpose of review In this manuscript, we review the diagnosis, causes, and management of cardiac thrombosis in children with congenital and acquired heart disease. Indications for invasive management and surgery are discussed. The differential diagnostic considerations and management of cardiac thromboses will be reviewed, including those that occur as a consequence of repair and palliation of congenital heart disease. Recent findings The definition of venous thromboembolism has recently been expanded to include thromboses within both the right and left heart chambers. Direct thrombin inhibitors (DTIs) and direct oral anticoagulants (DOACs) are emerging as treatment alternatives to the heparins and vitamin K antagonists for the management of thrombosis in pediatric heart disease. Summary Thrombosis within the heart occurs as a consequence of abnormalities and alterations in blood flow resulting in stasis and turbulence. Children with acquired and congenital heart disease carry a number of risk factors in Virchow’s triad. Thrombosis can occur throughout any part of the cardiovascular system in congenital heart disease and after surgery for repair or palliation of defects.