[Massive endocardial thrombosis in a patient with a peritoneo-jugular shunt for refractory ascites: the therapeutic success of tissue plasminogen activator and defibrotide].

The authors report a case of a patient with a refractory ascites due to extrahepatic portal thrombosis in course of idiopathic thrombocythemia. A peritoneovenous shunt was applied and as a late complication a massive thrombosis of the intracardiac portion of the duct developed. Thrombolysis was obtained with tissue plasminogen activator at doses usually administered for acute myocardial infarction. Prophylaxis of recurrence was pursued with pictomide and defibrotide.