Multifactorial Neonatal Thrombosis in Inferior Vena Cava Dislodged to the Right Atrium: A Case Report

Document Type : Case Report


Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran


Background: Neonatal thrombotic diseases can cause mortality or serious morbidity and disability.
Case report: In this report, we present a case of neonatal inferior vena cava thromboembolism with several underlying
factors. Hereditary thrombophilia and genetic mutation in plasminogen activator inhibitor-1 and MTHFR A1298C genes
in conjunction with cleft palate resulted in poor lactation and hypernatremic dehydration. A peripherally inserted
central catheter in the inferior vena cava was an additional underlying factor. Thrombosis mass was dislodged to the
right atrium while asymptomatic and accidentally detected during routine echocardiography.
Conclusion: Surgical thrombectomy was done successfully, and the mass was removed from the right atrium.


1. Hbibi M, Abourazzak S, Babakhouya A, Boubou M, Atmani S, Tizniti S, et al. Severe hypernatremic dehydration associated with cerebral venous and aortic thrombosis in the neonatal period. BMJ Case Reports. 2012; 2012:bcr0720114426.
2. Saxonhouse MA. Thrombosis in the neonatal intensive care unit. Clin Perinatol. 2015 Sep;42(3):651-73.
3. Will A. Neonatal hemostasis and the management of neonatal thrombosis. British Journal Of Hematology.2015; 169(3):324-32.
4. Van Elteren H, Veldt H, Te Pas A, Roest A, Smiers F, Kollen W, et al. Management and outcome in 32 neonates with thrombotic events. International Journal Of Pediatrics. 2011; 2011:217564.
5. Yang JY, Chan AK. Pediatric thrombophilia. Pediatric Clinics. 2013; 60(6):1443-62.
6. Sellitto M, Messina F. Central venous catheterization and thrombosis in newborns: update on diagnosis and management. Journal of Maternal- Fetal and Neonatal Medicine. 2012; 25(4):18.
7. Ulloa-Ricardez A, Romero-Espinoza L, de Jesús Estrada-Loza M, González-Cabello HJ, Núñez-Enríquez JC. Risk factors for intracardiac thrombosis in the right atrium and superior vena cava in critically ill neonates who required the installation of a central venous catheter. Pediatrics & Neonatology. 2016; 57(4):288-94.
8. Bessell A, Hooper L, Shaw WC, Reilly S, Reid J,Glenny AM. Feeding interventions for growth and development in infants with cleft lip, cleft palate or cleft lip and palate. The Cochrane Library. 2011.
9. Boccioni V, Attie M, Donato H, Comité Nacional de Hematología OyMT. Thrombosis in newborn infants. Arch Argent Pediatr. 2016; 114(2):159-66.
10. Greenway A, Massicotte MP, Monagle P. Neonatal thrombosis and its treatment. Blood reviews. 2004;18(2):75-84.
11. Sobczak A, Kruczek P, Homa M, Kwinta P. A new microscopic insight into the thrombogenicity of umbilical catheters. Thrombosis Research. 2018;168:80-–82
12. Konstantinides S, Torbicki A. Management of venous thromboembolism: an update. European heart journal. 2014; 35(41):2855-63.
13. Shah PS, Shah VS. Continuous heparin infusion to prevent thrombosis and catheter occlusion in neonates with peripherally placed percutaneous central venous catheters. 2008.
14. Klassen AF, Tsangaris E, Forrest CR, Wong KW, Pusic AL, Cano SJ, et al. Quality of life of children treated for cleft lip and/or palate: a systematic review. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2012; 65(5):547-57.
15. Morales J, Sabharwal T, Tibby S, Burnand K.Successful thrombolysis of asymptomatic neonatal aortic thrombosis associated with hypernatraemic dehydration–case report and literature review.International Journal Of Clinical Practice. 2008;62(3):502-5.