Acute aortic occlusion and secondary heart failure in a 6 month-old infant: Thrombolytic treatment
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Abstract
DOI: 10.1016/j.rcpe.2016.04.002
Aortic occlusion in neonates is rare, but can be devastating, leading to death or long-term complications that severely impair the quality of life (heart failure, kidney failure, lower limb amputation, mesenteric ischaemia, among others). The main cause of aortic occlusion in neonates is umbilical artery catheterisation. Other causes, such as hypercoagulable syndromes, blunt abdominal trauma, or cardiac diseases, such as myocarditis, structural abnormalities of the heart are also important in producing thrombi.
A case is presented of an infant with acute aortic occlusion, secondary to left a ventricular cardiac embolism of a thrombus secondary to viral myocarditis, which led to lower limb ischaemia and severe heart failure. It was managed with endovascular intra-arterial aortic thrombolysis with complete recanalisation and reversal of heart failure.
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References
Trastornos trombóticos de la coagulación: trombosis y tratamiento antitrombótico en niños
An Pediatr Contin., 5 (2007), pp. 189-196
2 C.E. Jiménez,D. Peña
Tratamiento endovascular del trauma vascular periférico
Rev Col Cir., 27 (2012), pp. 290-297
3 C.E. Jiménez,L. Randial,J.P. Rozo,N. Vélez
Malformación vascular hepática con falla cardiaca secundaria en un infante de dos meses, manejada con ónix, presentación de un caso y revisión de la literatura
Pediatr., 48 (2015), pp. 106-112
4 Ch. Roberto,M. Germano,T. Yamume,C. Efrem,E. Marone,L. Bertoglio
Endovascular treatment of aortic arch aneurysms
J Vasc Bras., 7 (2008), pp. 90-98
5 N. Andersen,J. Williams,H. Jennifer,A. Asad,R. McCann,G. Hughes
Results with an algorithmic approach to hybrid repair of the aortic arch
J Vasc Surg., 57 (2013), pp. 655-667 http://dx.doi.org/10.1016/j.jvs.2012.09.039
Medline
6 G.K. Lofland,P. Russo,B. Sethia,M. de Leval
Aortic thrombosis in neonates and infants
Ann Surg., 208 (1988), pp. 743-745
Medline
7 A. Arshad,M.J. McMcarthy
Management of limb ischemia in neonate and infant
Eur J Vasc Endovasc Surg., 38 (2009), pp. 61-65 http://dx.doi.org/10.1016/j.ejvs.2009.03.010
Medline
8 P. Himmel,S. David,C.H. Mongkolsmai,N. Khanna
Neonatal thoracoabdominal aortic thrombosis associated with the umbilical catheter. Successful management by trans aortic thrombectomy
J Vasc Surg., 4 (1986), pp. 119-123 http://dx.doi.org/10.1016/j.jvsv.2015.06.005
Medline
9 E. Hatch,J. Burrington
Neonatal aortic occlusion with successful embolectomy
J Pediatr Surg., 6 (1971), pp. 665
Artículo | Medline
10 J. Bontadelli,A. Moeller,J. Schmugge Mallowany,P. Mobagel,D. Knoppert
Enoxaparin therapy for arterial thrombosis in infants with congenital heart disease
Intensive Care Med., 33 (2007), pp. 1978-1984 http://dx.doi.org/10.1007/s00134-007-0718-8
Medline
11 G.T. Knowlson,H.B. Marsden
Aortic thrombosis in the newborn period
Arch Dis Child., 53 (1978), pp. 164-166
Medline
12 C.E. Jimenez,C. Pedraza,E. Alvarado
Safety and efficacy of thrombolysis in peripheral arterial occlusion
Técnicas endovasculares, 16 (2013), pp. 26-35
13 C. Stout,G. Koehl
Aortic embolism in a newborn infant
Am J Dis Child., 120 (1970), pp. 74-76
Medline
14 J. Marques,C. Gonçalve
Post-catheterisation arterial thrombosis in children — pathophysiology, prevention, and treatment
Cardiol Young, 24 (2014), pp. 767-773 http://dx.doi.org/10.1017/S1047951114000171
Medline
15 C.R. Kirk,C. Bhrolchain,S. Qureshi
Streptokinase for aortic thrombosis
Arch Dis Child., 63 (1988), pp. 1086-1087
Medline
16 J. Hartmann,A. Hussein,E. Trowitzsch
Treatment of neonatal thrombus formation with recombinant tissue plasminogen activator: Six years experience and review of the literature
Arch Dis Child Fetal Neonatal Ed, 85 (2001), pp. F18-F22
Medline
17 B. Jasani,R. Nanavat
Neonatal aortic thrombosis as a result of congenital homocystinuria
Indian Pediatr., 50 (2013), pp. 1054-1055
Medline
18 N. Krause,H. Schneider,M. Webel,T. Paul
Thrombosis of the aorta abdominalis in infants diagnosis and thrombolytic therapy
Klin Padiatr, 224 (2012), pp. 179-182 http://dx.doi.org/10.1055/s-0031-1295421
Medline
19 C. Berger,M. Françoise,C. Durand,D. Sandre,J.B. Gouyon
Use of tissue plasminogen activator in the treatment of aortic thrombosis in newborn infants
Arch Pediatr., 1 (1994), pp. 1014-1018
Medline
20 E. Chaikof,T. Dodson,A. Salam,B. Lumsden,R. Smith
Acute arterial thrombosis in the very young
J Vasc Surg., 16 (1992), pp. 428-435
Medline
21 G.N. Vailas,R.T. Brouillette,J.P. Scott,A. Shkolnik,J. Conway,K. Wiringa
Neonatal aortic thrombosis: Recent experience
J Pediatr., 109 (1986), pp. 101-108
Medline
22 J. Godoy,C. DeMarchi,M. Fonseca,C. Monteiro,A. Moscardini
Thrombosis of the abdominal aorta in a newborn: Case report and review of literature
J Pediatr Surg, 38 (2003), pp. 11-12
23 M. Nagel,R. Tuckuviene,B. Paes,A.K. Chan
Neonatal aortic thrombosis: A comprehensive review
Klin Padiatr, 222 (2010), pp. 134-139 http://dx.doi.org/10.1055/s-0030-1249662
Medline