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Thrombotic occlusion of Blalock-Taussig shunt in a patient with unnoticed protein C deficiency
Manabu Watanabe1, Mitsuru Aoki, Tadashi Fujiwara
1Unit of Cardiovascular Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, 1-1 Kanayama, Teine-ku, Sapporo, Hokkaido 006-0041, Japan. dookuman@beige.ocn.ne.jp
Abstract:
A 6-month-old girl with a diagnosis of double-outlet right ventricle and pulmonary stenosis had a left modified Blalock-Taussig shunt. Chest computed tomography (CT) performed on postoperative day 11 showed good patency of the shunt. However, on postoperative day 16, oxygen saturation suddenly dropped below 40%, and chest CT showed thrombotic occlusion of the shunt. Urgent thrombectomy was performed successfully. Examination of coagulation factors revealed low levels of both the amount and activity of protein C (27% and 31%, respectively). Diagnosis of heterozygous hereditary protein C deficiency was made, and the patient was placed on warfarin. She is currently in good condition.
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