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Thrombus formation after the Fontan operation.

P D Coon1, J Rychik, R T Novello

  • 1Cardiac Center at the Children's Hospital of Philadelphia, PA 19104, USA.

The Annals of Thoracic Surgery
|June 28, 2001
PubMed
Summary
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Thrombus formation after Fontan operation is common and occurs equally across different surgical modifications. This suggests thrombus development is inherent to the Fontan physiology, not the specific surgical approach.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease Surgery
  • Cardiovascular Physiology

Background:

  • Thrombus formation is a frequent complication following the Fontan operation.
  • Understanding thrombus prevalence and location is crucial for patient management.

Purpose of the Study:

  • To investigate the frequency and anatomical location of intracardiac thrombus in children post-Fontan operation.
  • To determine if thrombus formation varies based on the type of Fontan surgical modification.

Main Methods:

  • Retrospective analysis of 592 patients undergoing echocardiography after Fontan operation (1987-1999).
  • Evaluation of thrombus presence, location, and correlation with surgical type (atriopulmonary vs. lateral tunnel) and fenestration.

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Main Results:

  • Intracardiac thrombus was identified in 8.8% of patients.
  • Thrombus locations included systemic venous atrium (48%), pulmonary venous atrium (44%), and others.
  • No significant difference in thrombus freedom was observed based on surgical type or fenestration.

Conclusions:

  • Thrombus formation after Fontan operation occurs with similar frequency across different surgical modifications.
  • The findings suggest thrombus development is an intrinsic aspect of Fontan physiology, irrespective of surgical technique.