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Neonatal aortic arch thrombosis: analysis of thrombophilic risk factors and prognosis
- Source :
- Cardiology in the Young. 24:33-39
- Publication Year :
- 2013
- Publisher :
- Cambridge University Press (CUP), 2013.
-
Abstract
- Arterial thrombosis in neonates and children is a rare event and is often associated with external risk factors such as asphyxia or sepsis. We report our experiences with two neonates with spontaneous aortic arch thrombosis mimicking aortic coarctation. Despite single case reports until now, no data exist for the underlying thrombophilic risk factors and prognosis of this rare event. Both patients were carriers of a heterozygous factor V Leiden mutation, which has been reported once before as a risk factor for aortic arch thrombosis. One of our patients was operated upon successfully and is alive. The second patient suffered a large infarction of the right medial cerebral artery and had a thrombotic occlusion of the inferior caval vein. The patient obtained palliative care and died at the age of 6 days. In the literature, we identified 19 patients with neonatal aortic arch thrombosis. Of the 19 patients, 11 (58%) died. Including the two reported patients, the mortality rate of patients with multiple thromboses was 80% (8/10) compared with 18% (2/11) for patients with isolated aortic arch thrombosis; this difference reached statistical significance (p = 0.009). The analysis of thrombophilic disorders revealed that factor V Leiden mutation and protein C deficiency seem to be the most common risk factors for aortic arch thrombosis.Conclusion:Neonatal aortic arch thrombosis is a very rare but life-threatening event, with a high rate of mortality, especially if additional thrombotic complications are present. Factor V Leiden mutation seems to be one important risk factor in the pathogenesis of this fatal disease.
- Subjects :
- Male
Aortic arch
Heterozygote
medicine.medical_specialty
Palliative care
Aortic Diseases
Coarctation of the aorta
Infarction
Aorta, Thoracic
Vena Cava, Inferior
Risk Factors
Protein C deficiency
medicine.artery
Internal medicine
medicine
Humans
Risk factor
Activated Protein C Resistance
Venous Thrombosis
Aorta
business.industry
Angiography
Infant, Newborn
Factor V
Protein C Deficiency
Infarction, Middle Cerebral Artery
Thrombosis
General Medicine
Prognosis
medicine.disease
Echocardiography
Pediatrics, Perinatology and Child Health
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 14671107 and 10479511
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Cardiology in the Young
- Accession number :
- edsair.doi.dedup.....34716c93fe16e6b6589918828ea4ab0a