Arterial Thrombosis Secondary to Cardiac Catheterization in Neonates

Year 2019, Volume: 46 Issue: 1, 109 - 118, 03.03.2019

Sara Erol , Banu Aydın Hasibe Gokce Cinar Tamer Yoldas Aysegul Zenciroglu

https://doi.org/10.5798/dicletip.534847

Abstract

Objective:
Cardiac catheterization is one of the basic procedures applied in the diagnosis
and treatment of cardiovascular diseases. Development of thrombosis is a
serious complication of catheterization. In this study, the frequency and the
factors affecting the development of arterial thrombosis were prospectively
evaluated in neonates who were subjected to diagnostic or interventional
cardiac catheterization.

Methods:
Twenty newborns that received femoral artery catheterization within 6-month
period were enrolled in this study. Blood samples were taken for complete blood
count, prothrombin, activated partial thromboplastin time, INR ratio and
mutations of factorV Leiden, prothrombin 20210A, methylenetetrahydrofolate
reductase C667T and A1298 before the procedure. 100 U/kg bolus of heparin was
infused during catheterization. 28 U/kg/hour infusion of heparin was given to
the patients with clinically suspected thrombosis during first few hours after
catheterization. Doppler ultrasonography was performed in all patients within 6
hours after catheterization.

Results:
The gestational age of patients ranged from 31 to 40 weeks (median 39). Mean
birth weight was 2996 ± 589 (1880-4000 gr). Arterial thrombosis was detected in
10 patients by Doppler USG. On development of arterial thrombosis, patient age,
gender, diagnosis, treatments, platelet count, hemoglobin, prothrombin and
activated partial thromboplastin time values, FactorV Leiden, prothrombin 20210A,
methylenetetrahydrofolate reductase C667T and A1298 mutations were found as not
impacting (p>0.05). Those who were found to have thrombosis in Doppler
ultrasonography had lower INR levels compared to others (p= 0.023).

Conclusions:
The rate of femoral arterial thrombosis in newborns after catheterization
detected by Doppler ultrasonography was 50% in this study. Our data suggest
that early clinical assessment for the diagnosis of thrombosis may be
misleading but Doppler ultrasonography may be helpful early detection. Further
studies are needed to prediction appropriate drugs and/or doses for prevention
of thrombosis after arterial catheterization in newborns.

Keywords

newborn, thrombosis

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