Subtotal thrombosis of the juxtaductal thoracic aorta in a premature 36 weeks baby: Treatment by alteplase.

The authors report the case of a neonate, a premature 36 weeks gestation ma le child who presented with a spontaneous thrombosis of the juxtaduetal aor ta at 3 days of age. The clinical presentation mimicked that of severe coarctation with cardioci rculatory failure. The diagnosis was ineffective, the introduction of low d ose alteplase (plasma activator of human recombinant plasminogen) with cont inued anticoagulation resulted in near complete lysis of the clot and avoid ed surgery. Thromboembolic cerebral and renal complications were observed during treatm ent. However, 6 months after the acute episode, there were no clinical or e chographic sequellae. Global renal function remained normal despite mild at rophy of the parenchyma of the left kidney. This combined treatment represents an alternative to high risk surgery. The follow-up of this form of management should be rigorous in view of the pot ential renal and cerebral complications.