TY - JOUR
T1 - Management and follow-up of arterial thrombosis in the neonatal period
AU - Payne, R. Mark
AU - Martin, Thomas C.
AU - Bower, Richard J.
AU - Canter, Charles E.
N1 - Funding Information:
Aortic thrombosis in the neonatal period is a frequent complication of umbilical artery catheterization but is rarely seen as a congenital condition? ,2 The incidence of clinically significant thromboembolic events from UACs has been reported to be approximately 1%,3 and radio!ogi-cally detectable thrombi have been demonstrated in 20% to 95% of patients. 4,5 The morbidity and mortality rates for complete occlusions are high ~, 6. 7; the first successful surgical thrombectomy was described in 1981. 3 This is a report of our experience with 12 infants who had major arterial thrombus formation in the neonatal period; two of these infants had congenital arterial thrombosis. Five infants were treated surgically, and seven were managed medical- Supported, in part, by the Alpha Phi Sorority. Submitted for publication June 16, 1988; accepted Nov. 8, 1988. Reprint requests: R. Mark Payne, MD, Division of Pediatric Cardiology, Children's Hospital at Washington University, 400 S. Kingshighway, St. Louis, MO 63110.
PY - 1989/5
Y1 - 1989/5
N2 - The management and follow-up of 12 patients with major aortic thrombus formation occurring in the neonatal period between 1982 and 1987 are reported. Umbilical arterial catheters were inserted in 8 of the 12 patients before thrombus formation. Two patients had congenital thrombl. Hypertension, oliguria, hematuria, and elevated blood creatinine concentration were found at the time of diagnosis of the thrombus; nine of the patients had a patent ductus arteriosus. Supportive care was instituted in seven patients who were hemodynamically stable. Five of the patients had congestive heart failure, shock, or both, and were treated with surgical thrombectomy. Thrombolytic therapy was not used in either group. The five surgically treated patients and six of seven medically treated patients survived. Ultrasound examination suggested resolution of the thrombus in all survivors in 6 to 30 days. Sequelae from thrombus formation were present in all patients at the time of discharge and included hypertension in 9 of the 11 survivors and decreased renal function in six of them. Follow-up at 1 to 3 years revealed normal blood pressure, good growth, and good renal function in 10 of the survivors.
AB - The management and follow-up of 12 patients with major aortic thrombus formation occurring in the neonatal period between 1982 and 1987 are reported. Umbilical arterial catheters were inserted in 8 of the 12 patients before thrombus formation. Two patients had congenital thrombl. Hypertension, oliguria, hematuria, and elevated blood creatinine concentration were found at the time of diagnosis of the thrombus; nine of the patients had a patent ductus arteriosus. Supportive care was instituted in seven patients who were hemodynamically stable. Five of the patients had congestive heart failure, shock, or both, and were treated with surgical thrombectomy. Thrombolytic therapy was not used in either group. The five surgically treated patients and six of seven medically treated patients survived. Ultrasound examination suggested resolution of the thrombus in all survivors in 6 to 30 days. Sequelae from thrombus formation were present in all patients at the time of discharge and included hypertension in 9 of the 11 survivors and decreased renal function in six of them. Follow-up at 1 to 3 years revealed normal blood pressure, good growth, and good renal function in 10 of the survivors.
UR - http://www.scopus.com/inward/record.url?scp=0024605458&partnerID=8YFLogxK
U2 - 10.1016/S0022-3476(89)80152-0
DO - 10.1016/S0022-3476(89)80152-0
M3 - Article
C2 - 2715899
AN - SCOPUS:0024605458
SN - 0022-3476
VL - 114
SP - 853
EP - 858
JO - The Journal of Pediatrics
JF - The Journal of Pediatrics
IS - 5
ER -