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PEDIATRICS Vol. 109 No. 4 April 2002, pp. e67

ELECTRONIC ARTICLE

Treatment of Plastic Bronchitis in a Fontan Patient With Tissue Plasminogen Activator: A Case Report and Review of the Literature

John M. Costello, MD*,{ddagger}, David Steinhorn, MD{ddagger}, Susanna McColley, MD{ddagger}, Mark E. Gerber, MD§ and Sulekha P. Kumar, MD*

* Divisions of Cardiology, Children’s Memorial Hospital, Northwestern University Medical School, Chicago, Illinois
{ddagger} Division of Pulmonary and Critical Care Medicine, Children’s Memorial Hospital, Northwestern University Medical School, Chicago, Illinois
§ Division of Otolaryngology, Children’s Memorial Hospital, Northwestern University Medical School, Chicago, Illinois

--> Plastic bronchitis is a condition in which large, bronchial casts with rubber-like consistency develop in the tracheobronchial tree and cause airway obstruction. We describe a 4-year-old girl who had Fontan physiology and who developed plastic bronchitis and report for the first time the use of aerosolized tissue plasminogen activator for treatment of this condition. The literature is reviewed with emphasis placed on the occurrence of this disorder in patients with single ventricle physiology.

Key Words: plastic bronchitis • bronchial cast • Fontan • congenital heart disease • tissue plasminogen activator

Abbreviations: t-PA • tissue plasminogen activator

Received for publication Aug 3, 2001; Accepted Dec 13, 2001.