Occlusive aortic arch thrombus in a preterm neonate

Abstract

Neonatal aortic arch thrombus is extremely rare with only 3 cases previously reported--all in term infants. Therapeutic options include anticoagulation, thrombolytic therapy, and thrombectomy. The risk/benefit ratio for anticoagulation and thrombolytic therapy is unknown and must be individualized. This preterm infant was managed with low-risk therapy and had an optimal outcome.

Antithrombotic Therapy in Neonates and Children

“…[351][352][353][354][355][356][357][358][359][360][361] Many published cases have evidence of extensive thrombosis involving either the abdominal or the thoracic aorta, the later sometimes mimicking coarctation at presentation. 362 The outcome of these events is variable, but overall mortality appears to be relatively high.…”

Aortic arch thrombectomy in a 2.8 kilogram neonate – a case report and review of the literature

“…In one of the most recent reports, Francis et al 1 presented the case of an extremely preterm baby with occlusive aortic arch thrombus following the insertion of umbilical catheters. The large thrombus – located distal to the innominate artery and extending into the carotid artery – was successfully treated with intravenous heparin and subsequent low-molecular-weight heparin.…”

Doctor please feel my pulses! An aid to diagnosis in the newborn

“…If a duct is wide open, the femoral may be stronger than the brachialis in all of the left sided obstructive lesions such as coarctation of the aorta, interrupted aortic arch etc . or from a thrombus in the arch . In addition, because of the right to left shunt through the PDA, the saturations in the lower limbs may be less than in the arms depending on the cardiac abnormality.…”

“…5,6 or from a thrombus in the arch. 10 In addition, because of the right to left shunt through the PDA, the saturations in the lower limbs may be less than in the arms depending on the cardiac abnormality. That observation is used to good purpose by the neonatal oxygen saturation screening, law in some parts of the United States.…”