Biomaterial Database

Occlusive aortic arch thrombus in a preterm neonate. 2010

Johny Vakayil Francis, and Paul Monagle, and Sarah Hope, and Arvind Sehgal

Monash Newborn, Monash Medical Centre, VIC, Australia.

OBJECTIVE To present the case of an extremely preterm infant with occlusive aortic arch clot managed with low-risk therapy. METHODS Case details were obtained from medical records and echocardiographic images from Excelera database. METHODS Preterm infant with occlusive clot in the aortic arch. METHODS Demographic details (gestation age and birthweight), clinical and biochemical data (blood pressure, oxygen saturation, urine output, lactate levels, and coagulation profile) were obtained from medical records. A female infant was born at 28 wks gestation and had umbilical catheters inserted in satisfactory positions. On day 6, pre- and postductal oxygen saturation differences, a significantly higher blood pressure on right arm, and weak pulses were noted. Echocardiogram revealed an occlusive thrombus in the aortic arch distal to the innominate artery, extending into the carotid artery with retrograde flow in the left internal carotid and subclavian arteries. The distal aortic circulation was supported by ductus arteriosus shunting bidirectionally. Intravenous prostaglandin E and heparin were started, the latter was later replaced by enoxaparin. Serial echocardiograms over next 3 mos showed complete resolution of the thrombus. CONCLUSIONS 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.

UI	MeSH Term	Description	Entries
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D004452	Echocardiography	Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.	Echocardiography, Contrast,Echocardiography, Cross-Sectional,Echocardiography, M-Mode,Echocardiography, Transthoracic,Echocardiography, Two-Dimensional,Transthoracic Echocardiography,2-D Echocardiography,2D Echocardiography,Contrast Echocardiography,Cross-Sectional Echocardiography,Echocardiography, 2-D,Echocardiography, 2D,M-Mode Echocardiography,Two-Dimensional Echocardiography,2 D Echocardiography,Cross Sectional Echocardiography,Echocardiography, 2 D,Echocardiography, Cross Sectional,Echocardiography, M Mode,Echocardiography, Two Dimensional,M Mode Echocardiography,Two Dimensional Echocardiography
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000925	Anticoagulants	Agents that prevent BLOOD CLOTTING.	Anticoagulant Agent,Anticoagulant Drug,Anticoagulant,Anticoagulant Agents,Anticoagulant Drugs,Anticoagulation Agents,Indirect Thrombin Inhibitors,Agent, Anticoagulant,Agents, Anticoagulant,Agents, Anticoagulation,Drug, Anticoagulant,Drugs, Anticoagulant,Inhibitors, Indirect Thrombin,Thrombin Inhibitors, Indirect
D001013	Aorta, Thoracic	The portion of the descending aorta proceeding from the arch of the aorta and extending to the DIAPHRAGM, eventually connecting to the ABDOMINAL AORTA.	Aorta, Ascending,Aorta, Descending,Aortic Arch,Aortic Root,Arch of the Aorta,Descending Aorta,Sinotubular Junction,Ascending Aorta,Thoracic Aorta,Aortic Roots,Arch, Aortic,Ascending Aortas,Junction, Sinotubular,Root, Aortic,Sinotubular Junctions
D001157	Arterial Occlusive Diseases	Pathological processes which result in the partial or complete obstruction of ARTERIES. They are characterized by greatly reduced or absence of blood flow through these vessels. They are also known as arterial insufficiency.	Arterial Obstructive Diseases,Arterial Occlusion,Arterial Obstructive Disease,Arterial Occlusions,Arterial Occlusive Disease,Disease, Arterial Obstructive,Disease, Arterial Occlusive,Obstructive Disease, Arterial,Occlusion, Arterial,Occlusive Disease, Arterial
D013927	Thrombosis	Formation and development of a thrombus or blood clot in BLOOD VESSELS.	Atherothrombosis,Thrombus,Blood Clot,Blood Clots,Thromboses
D015278	Intensive Care Units, Pediatric	Hospital units providing continuous surveillance and care to acutely ill infants and children. Neonates are excluded since INTENSIVE CARE UNITS, NEONATAL is available.	ICU, Pediatric,Pediatric ICU,Pediatric Intensive Care Unit,Pediatric Intensive Care Units,ICUs, Pediatric,Pediatric ICUs
D047928	Premature Birth	CHILDBIRTH before 37 weeks of PREGNANCY (259 days from the first day of the mother's last menstrual period, or 245 days after FERTILIZATION).	Preterm Birth,Birth, Premature,Birth, Preterm,Births, Premature,Births, Preterm,Premature Births,Preterm Births