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[A right atrial thrombus after Fontan procedure--a case report]
K Hayashi1, K Suma, Y Takeuchi
1Department of Cardiovascular Surgery, Tokyo Women's Medical College 2nd Hospital, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|July 1, 1990
Summary
A modified Fontan procedure patient died from heart failure due to a right atrial appendage thrombus. Excising the appendage, anticoagulation, and regular echocardiography are recommended after this surgery.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- The modified Fontan procedure is a palliative surgical option for complex congenital heart defects like tricuspid atresia.
- Maintaining long-term patency and preventing thromboembolic complications are critical challenges following Fontan procedures.
Observation:
- A 17-year-old male with tricuspid atresia developed fatal heart failure 4.5 years post-modified Fontan operation.
- Autopsy revealed a significant thrombus within the right atrial appendage, identified as the likely cause of death.
Findings:
- Thrombus formation in the right atrial appendage is a potential and serious complication after modified Fontan procedures.
- The presence of the atrial appendage may contribute to thrombus development and subsequent adverse events.
Implications:
- Surgical excision of the right atrial appendage during modified Fontan procedures may reduce the risk of thromboembolism.
- Postoperative anticoagulation therapy and regular echocardiographic monitoring are crucial for early detection of thrombus formation.
- These findings highlight the importance of vigilant management strategies to improve long-term outcomes for Fontan patients.