Management of neonatal aortic arch thrombosis with low-molecular weight heparin: a case series.
Aortic arch thrombosis (AAT) is a potentially life threatening condition in neonates. We report 3 neonates with AAT and complete occlusion of a unilateral internal carotid artery with multiple cerebral infarcts. Multidisciplinary input led to deferral of thrombolytic therapy and surgical thrombectomy owing to the potential risk of hemorrhage within the infarcts. All the neonates were treated with low-molecular weight heparin treatment alone without any complications. Thrombus resolution was complete in 2 neonates, whereas it was near complete in one neonate. All the infants showed normal growth and development during follow-up. The rewarding outcome in these cases suggests that treatment with low-molecular weight heparin could be considered an option to treat AAT in selected patients.
Sharathkumar
Anjali Alatkar
AA
Indiana Hemophilia and Thrombosis Centre, St Vincent Women's Hospital parallelChildren's Heart Center, St Vincent Hospitals, Indianapolis, IN 46260, USA. asharathkumar@ihtc.org
Lamear
Nancy
N
Pipe
Steven
S
Parikh
Sanjay
S
Russell
Mark
M
Simon
Abrahim
A
Shapiro
Amy
A
D000925:Anticoagulants / Q000627:therapeutic use*; D001013:Aorta, Thoracic / Q000473:pathology*; D001018:Aortic Diseases / Q000150:complications / Q000188:drug therapy*; D002340:Carotid Artery Diseases / Q000188:drug therapy / Q000473:pathology; D002544:Cerebral Infarction / Q000188:drug therapy / Q000209:etiology; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight