We report the case of 24-year-old woman who presented with ductal aneurysm 7 years after a triple ligation of a patent ductus arteriosus. She underwent successful repair through median sternotomy and under moderate hypothermic circulatory arrest and selective cerebral perfusion.

Aortic arch thrombus is a rare occurrence in neonates. In the few described cases, this has mainly been associated with sepsis or early postnatal interventions, such as insertion of umbilical arterial line. We describe a case of occlusive aortic arch thrombus in a neonate who presented with signs of critical coarctation and successfully underwent surgical thrombectomy on deep hypothermic circulatory arrest. We also present a review of the most recently published cases of aortic arch thrombus in neonates and the treatment options employed.

Cardiopulmonary bypass in neonates is markedly different from the procedure used in children above 10 kg and in adults. There are two major reasons for this—first, the mismatch between the volume of the heart-lung machine circuit and that of the blood in the patient and second, the immaturity of tissues in the first three months of life.