Acute thrombosis of extracardiac conduit after the Fontan operation: an emergent thrombectomy

Ahmet Kırbaş; Yalım Yalçın; Nursen Tanrıkulu; Ömer Işık

doi:10.5606/tgkdc.dergisi.2013.6588

Ahmet Kırbaş¹, Yalım Yalçın², Nursen Tanrıkulu³, Ömer Işık¹

¹Department of Cardiovascular Surgery, Medicana Çamlıca Hospital, İstanbul, Turkey
²Department of Pediatric Cardiology, Medicana Çamlıca Hospital, İstanbul, Turkey
³Department of Anaesthesiology and Reanimation, Medicana Çamlıca Hospital, İstanbul, Turkey

DOI : 10.5606/tgkdc.dergisi.2013.6588

Fontan operation is applied as palliative therapy in different type of complex congenital heart disease. Thrombosis remains a major complication after Fontan surgery, presenting as intracardiac and/or intravascular thrombosis, or other embolic phenomena. A nine-yearold boy underwent surgery to correct transposition of the great arteries, ventricular septal defect, pulmonary valve atresia by extracardiac Fontan procedure using 16 mm Dacron graft. During surgery and recovery, no adverse events were observed. On the 18^th day after surgery, the patient developed sudden signs of low cardiac output, dyspnea, and right ventricular insufficiency. Angiography and echocardiography demonstrated complete occlusion of extracardiac conduit. We have performed emergent surgical thrombectomy without cardiopulmonary bypass to the patient. The postoperative period was uneventful and the patient was discharged on the 60^th day.

Keywords : Congenital heart disease; Fontan procedure; thromboembolism

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