Klimek Jan, Culcer Mihaela, Veerappan Sundar
NICU, Westmead Hospital, Corner Darcy and Hawkesbury Roads, Westmead, Sydney, NSW 2145, Australia.
Cardiology Department, Children's Hospital at Westmead, Hawkesbury Road, Westmead, Sydney, NSW 2145, Australia.
Eur Heart J Case Rep. 2023 Jul 19;7(7):ytad312. doi: 10.1093/ehjcr/ytad312. eCollection 2023 Jul.
There is currently a lack of evidence-based guidelines regarding ideal management of a neonate, specifically a preterm, with thrombo-embolus. There are no clear guidelines as to the time-frame of spontaneous resolution of a thrombo-embolus.
A large pedunculated right atrial mass was identified on a clinician-performed cardiac ultrasound in a preterm neonate. The mass was smaller than half of the atrial size and was not causing obstruction. The mass disappeared spontaneously within 6 days and was retrospectively presumed to have been a thrombus. The neonate remained asymptomatic with no signs suggesting that the mass may have embolized.
In this case of an incidentally identified asymptomatic intracardiac mass in a preterm infant, presumed to be a thrombus, our conservative 'wait and watch' approach was not associated with any adverse pulmonary or systemic effects.
目前缺乏关于新生儿,特别是早产儿血栓栓塞理想管理的循证指南。关于血栓栓塞自发溶解的时间框架尚无明确指南。
一名早产儿经临床医生进行心脏超声检查时发现右心房有一个带蒂的大肿块。该肿块小于心房大小的一半,未造成梗阻。肿块在6天内自发消失,回顾性推测为血栓。新生儿无症状,无迹象表明肿块可能已发生栓塞。
在这个早产儿偶然发现无症状心内肿块、推测为血栓的病例中,我们保守的“观察等待”方法未产生任何不良肺部或全身影响。