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Cuervas-Mons Tejedor, J.D. López Castilla, E. Sánchez Valderrábanos" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Cuervas-Mons Tejedor" ] 1 => array:4 [ "nombre" => "J.D." "apellidos" => "López Castilla" "email" => array:1 [ 0 => "pepedomi1953@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Sánchez Valderrábanos" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Gestión Clínica de Cuidados Intensivos Pediátricos. Hospital Infantil Virgen del Rocío, Sevilla. Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento fibrinolítico con activador tisular del plasminógeno en paciente con tromboembolismo pulmonar masivo y trombosis de la anastomosis de Glenn" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 918 "Ancho" => 1262 "Tamanyo" => 100533 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 16-year-old female presented with a history of complex congenital heart disease requiring a right systemic-pulmonary fistula, with a bidirectional cavopulmonary anastomosis (Glenn procedure) at 6 years of age. She was admitted to the Pediatric Intensive Care Unit due to breathing difficulty and severe hypoxemia. With the suspicion of pulmonary thromboembolism, heparin sodium was started, and a new CT angiographic study was performed 24 hours later due to progressive clinical worsening. A thrombus was identified at the communication between the left superior vena cava and the left pulmonary artery, compatible with massive thromboembolism of the left lung (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, see arrows). Treatment was started with recombinant tissue plasminogen activator (rTPA) in the form of an initial 30 mg bolus (0.5 mg/kg) followed by the perfusion of 0.04 mg/kg/h. After 36 hours, repeat control CT angiography evidenced important thrombus reduction with marked re-permeation (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>, see arrows).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors declare that no funding has been received for this study.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 956 "Ancho" => 1262 "Tamanyo" => 101053 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 918 "Ancho" => 1262 "Tamanyo" => 100533 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004700000004/v1_202303262126/S2173572722001497/v1_202303262126/en/main.assets" "Apartado" => array:4 [ "identificador" => "64602" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Intensive Medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004700000004/v1_202303262126/S2173572722001497/v1_202303262126/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572722001497?idApp=WMIE" ]
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