Arterial Thrombolysis In The Neonate By Recombinant Tissue-Plasminogen Activator (Rtpa)

In two neonates, aortic thrombosis induced by arterial catheter was located in abdominal aorta extended to the right renal artery; one induced right leg cyanosis and the other was identified by echo control of aortic catheter. In the third neonate, left atrial thrombosis was induced by the tip of a wire, positioned in left atria during aortic valvuloplasty and showed by post catheterim 2D echo control. The fourth neonate showed asystole related to myocardial ischemia after flushing a catheter inadvertently positioned in ascending aorta. In this case rtPA was immediately infused into the catheter which was then withdrawn. The three other neonates received a bolus rtPA 0.1 mg/kg/10 min followed by 0.9 mg/kg/3 hours then heparin 100 Ul/kg/h.