Successful treatment of aortic root thrombus and neonatal myocardial infarction with systemic tissue plasminogen activator

Abstract

Neonatal myocardial infarction portends a grim prognosis, especially when severe left ventricular (LV) dysfunction is also seen. This report describes a 1-day-old with an uncomplicated prenatal course and delivery who presented with bacteremia and an aortic root thrombus, which led to left main coronary artery (LMCA) ischemia on day of life 1. He was treated with systemic tissue plasminogen activator with complete thrombus resolution, effectively restoring LMCA flow. With the addition of guideline-directed medical therapy, his LV function improved.