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[The pulmonary artery closure may be a thromboembolic risk factor in patients with bidirectional cavo-pulmonary
F Villagrá1, J Pérez De León, M Rodríguez
1Servicio de Cirugía Cardíaca y Cardiología Infantil. Clínica de la Zarzuela. Madrid, Spain. Villabert@bitmailer.net
Insights
Thrombosis after the bilateral cavo-pulmonary shunt (Glenn) is rare but can cause cerebral embolism. This occurs due to dislodged thrombi from the pulmonary artery stump, prompting further research into prevention.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Thromboembolic Disease
Background:
- Postoperative thrombosis is a known complication following the Fontan procedure.
- Thrombosis after the bilateral cavo-pulmonary shunt (Glenn) is infrequently reported and typically localized near the anastomosis.
Observation:
- Two cases of cerebral embolism are presented, occurring 2-7 months after pulmonary artery closure and Glenn procedure.
- The embolism resulted from the dislodgement of a thrombus located in the proximal pulmonary artery stump.
Findings:
- This presentation highlights a novel cause of thromboembolism in patients who have undergone the Glenn procedure.
- The findings suggest a potential complication distinct from typical Glenn-associated thrombosis.
Implications:
- Increased awareness is needed regarding this specific cause of thromboembolism after the Glenn procedure.
- Further investigation into the incidence, risk factors, and preventive strategies for this complication is warranted.
Abstract:
Postoperative thrombosis after the Fontan procedure has been well noted in the literature, and its risk factors are also well known. In contrast, thrombosis after the bilateral cavo-pulmonary shunt (Glenn) has been rarely reported and almost always occurs around the anastomosis itself or near it, mainly causing pulmonary embolism. We present 2 cases with cerebral embolism 2-7 months after pulmonary artery closure and Glenn procedure, due to dislodgement of a thrombus in the proximal pulmonary artery stump. Based on these two cases and a few others reported in the literature, we want to call the attention to this new cause of thromboembolism after Glenn and stimulate discussion about its incidence, risk factors and preventive measures.