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Published on: November 2, 2019
Management of neonatal and infant aortic thrombosis: A single-center case series
Ajibike Lapite1, Mohammad H Abu-Arja1, Hyojeong Han2,3
1Division of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Cancer and Hematology Center, Houston, Texas, USA.
Insights
Neonatal aortic thrombosis is a rare but serious condition in infants. Treatment involving thrombolysis or thrombectomy showed positive results with manageable complications, suggesting their consideration in management.
Area of Science:
- Pediatrics
- Cardiovascular Medicine
- Neonatology
Background:
- Neonatal and infant aortic thrombosis is a rare, life-threatening condition.
- Premature infants with arterial catheters are particularly at risk.
Purpose of the Study:
- To describe the institutional experience and management approach for neonatal/infant aortic thrombosis.
- To evaluate the efficacy and safety of thrombolysis and thrombectomy in this population.
Main Methods:
- Retrospective review of 11 infants with occlusive or nearly occlusive aortic thrombosis.
- Analysis of management strategies, including thrombolytic therapy and anticoagulation.
- Assessment of treatment outcomes and complications.
Main Results:
- All 11 infants experienced at least partial thrombus resolution.
- Minor bleeding occurred in two patients receiving thrombolysis.
- Two major bleeding events were observed in patients receiving anticoagulation alone.
Conclusions:
- Thrombolysis and thrombectomy should be considered in the management of neonatal/infant aortic thrombosis.
- These interventions demonstrate efficacy in achieving thrombus resolution.
- Careful monitoring for bleeding complications is essential during treatment.
Abstract:
Neonatal and infant aortic thrombosis is a rare albeit life-threatening thrombotic event, particularly seen in premature infants with an arterial catheter in place. We describe our institutional experience and approach to the management of 11 infants with occlusive or nearly occlusive aortic thrombosis. We observed at least partial thrombus resolution in all patients. Complications related to our management included minor bleeding in two children receiving thrombolytic therapy, and two major bleeding events in children receiving anticoagulation alone. Our experience adds to the growing body of evidence that thrombolysis and thrombectomy should be considered in managing neonatal/infant aortic thrombosis.
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