In Utero Aortic Arch Thrombosis Masquerading as Interrupted Aortic Arch: A Case Report and Review of the Literature

Pediatr Cardiol. 2019 Mar;40(3):658-663. doi: 10.1007/s00246-019-02068-5. Epub 2019 Feb 8.


Aortic arch thrombosis is an extremely rare but life-threatening diagnosis that is often misdiagnosed in the neonatal period. Strategies including surgical intervention, systemic anticoagulation, and thrombolysis have been previously described in the treatment of these neonates. We describe the case of a neonate who presented with concern for interrupted aortic arch and was diagnosed with an in utero aortic arch thrombosis. To our knowledge, this is the first reported case with evidence of aortic arch thrombosis in fetal life. The patient underwent successful treatment with systemic thrombolysis with tissue plasminogen activator. A brief review of the literature regarding the diagnosis, treatment, and management of neonatal aortic arch thrombosis is also presented.

Keywords: Aortic arch thrombosis; Neonatal; Systemic thrombolysis; Thrombosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aorta, Thoracic / pathology*
  • Aortic Diseases / diagnosis*
  • Aortic Diseases / drug therapy
  • Computed Tomography Angiography / methods
  • Diagnosis, Differential
  • Echocardiography / methods
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Infant, Newborn
  • Magnetic Resonance Imaging / methods
  • Male
  • Thrombolytic Therapy / methods
  • Thrombosis / diagnosis*
  • Thrombosis / drug therapy
  • Tissue Plasminogen Activator / therapeutic use*


  • Fibrinolytic Agents
  • Tissue Plasminogen Activator