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Aortic thrombosis in the neonate

R C McFaul, J F Keane, E R Nowicki

    The Journal of Thoracic and Cardiovascular Surgery
    |March 1, 1981
    PubMed
    Summary

    Two infants with aortic thrombosis experienced obstructive aortic arch lesions. Despite surgical intervention, both infants tragically died post-operation, highlighting critical challenges in managing this rare condition.

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    Area of Science:

    • Pediatric Cardiology
    • Neonatal Surgery
    • Vascular Biology

    Background:

    • Aortic thrombosis is a rare but serious condition in infants, often presenting with complex obstructive aortic arch lesions.
    • Early diagnosis and intervention are crucial for managing neonatal aortic thrombosis, yet noninvasive methods can be inconclusive.

    Observation:

    • Two infant cases presented with clinical signs suggestive of obstructive aortic arch lesions, including pressure gradients and unequal pulses.
    • Echocardiography revealed severe left ventricular dysfunction, but noninvasive studies were insufficient for definitive diagnosis.
    • Cardiac catheterization with angiography was essential in defining the obstruction's severity and the thrombus location in both infants.

    Findings:

    • Aortic thrombus originated from a ductus arteriosus aneurysm in one infant and was located in the ascending aorta and transverse arch in the other.
    • Surgical removal of the aortic thrombus was technically successful in both cases.
    • Despite successful surgery, both infants experienced unexpected mortality in the early postoperative period.

    Implications:

    • This case series underscores the diagnostic challenges and poor prognosis associated with aortic thrombosis in neonates.
    • Further research into optimal diagnostic strategies and management protocols for infantile aortic thrombosis is warranted.
    • Understanding the etiology and pathophysiology of aortic thrombosis in this population is critical for improving outcomes.

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