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Case report
Bivalirudin and thrombolytic therapy: a novel successful treatment of severe aortic arch thrombosis in a term neonate
  1. Amjad Taha1,
  2. Ayan Rajgarhia1,2 and
  3. Mahdi Alsaleem1,3
  1. 1Pediatrics, Children's Mercy Hospital, Kansas City, Missouri, USA
  2. 2Pediatrics, University of Missouri Kansas City, Kansas City, Missouri, USA
  3. 3Department of Pediatrics, University of Kansas School of Medicine Wichita, Wichita, Kansas, USA
  1. Correspondence to Dr Mahdi Alsaleem; malsaleem{at}cmh.edu

Abstract

An early-term infant with uncomplicated perinatal history was found to have a large thrombus in the aortic arch after he failed regular newborn critical congenital heart defect screen. He responded well to bivalirudin thrombolytic and tissue-plasminogen activator (tPA) combination therapy, with a significant resolution of the thrombus. The infant tolerated hospital admission well with no significant complications. He was discharged home on daily aspirin at 2 weeks of life. To our knowledge, the combination therapy approach with bivalirudin and tPA is the first one reported in the literature in the neonatal age group.

  • cardiovascular system
  • haematology (drugs and medicines)
  • paediatrics (drugs and medicines)
  • neonatal intensive care
  • routine care of the full-time infant

https://doi.org/10.1136/bcr-2020-239535

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    Footnotes

    • Contributors MA, AT and AR contributed to the design, draft and revision for this report. MA extensively revised this draft and contributed to the design of the revised paper. All authors approved the final version of this draft and agreed to be accountable for all aspects of the work; ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MA drafted figure 5 included in this revised article and it was not copied from another source.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.