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Volume 341:1082-1083 September 30, 1999 Number 14
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Treatment of Mobile Left Ventricular Thrombus with Low-Molecular-Weight Heparin

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To the Editor: About a third of patients with dilated cardiomyopathies have left ventricular thrombi.1 Mobile thrombi have a high rate of systemic embolization. Definitive treatment of these thrombi has yet to be established. Oral anticoagulation has had variable success, with resolution rates ranging from 13 to 59 percent.2 Thrombolysis with urokinase, streptokinase, and tissue plasminogen activator has been reported, but the risks of hemorrhagic or embolic complications may be unacceptably high.3 Surgical thrombectomy is also advocated,4 but generally patients with dilated cardiomyopathies are at an increased risk for perioperative morbidity and mortality. High-dose intravenous heparin effectively treats thrombi that . . . [Full Text of this Article]

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