Embolic stroke after total cavopulmonary connection for complex congenital heart disease - A case report

Tsyr Yuh Ho, Betau Hwang, Pi Chang Lee, Jen Her Lu, Chi Ming Liang, Chung Chang Laura Meng

Research output: Contribution to journalArticlepeer-review

Abstract

Thrombosis has been reported to occur variably from 1 day to more than 10 years after Fontan-type operation. We herein describe a case with heterotaxy syndrome with situs ambiguous, dextrocardia, single ventricle, complete atrioventricular canal defect, malposition of great arteries and bilateral superior vena cava who had received pulmonary artery banding and total cavopulmonary connection at the ages of 2 months and 4 years, respectively. However, he was lost to follow-up. Eleven years after the operation, the patient suffered from acute cerebral infarction of right middle cerebral artery territory, which was documented by brain computed tomography. Multiple venous thrombi were detected by suprasternal approach of two-dimensional transthoracic echocardiography and cardiac angiography during hospitalization. The patient finally expired in spite of aggressive treatment. We suggest that transthoracic and/or even transesophageal echocardiography should be performed as a routine surveillance for cardiac function evaluation as well as for thrombus detection in patients after cavopulmonary connection. In addition, long-term use of oral anticoagulant may be necessary, especially when patients have low cardiac output and/or high atrial pressure.

Original languageEnglish
Pages (from-to)176-181
Number of pages6
JournalActa Cardiologica Sinica
Volume20
Issue number3
Publication statusPublished - Sep 2004
Externally publishedYes

Keywords

  • Anticoagulant
  • Cavopulmonary connection
  • Cerebral infarction
  • Fontan-type operation
  • Stroke
  • Thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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