[Plastic bronchitis in a ten year-old boy with Fontan circulation]

Area of Science:

• Pediatric Cardiology
• Pulmonary Medicine
• Critical Care

Background:

• Plastic bronchitis is a rare but serious complication in children, particularly those with inflammatory lung disease or following the Fontan operation for congenital heart disease.
• It is characterized by the production of extensive bronchial casts, posing a risk of fatal airway obstruction.

Observation:

• A case report details a ten-year-old boy with transposition of the great arteries and hypoplastic right ventricle who had a Fontan operation at age three.
• Seven years post-Fontan, the patient developed plastic bronchitis.

Findings:

• The patient's plastic bronchitis was managed with a multi-modal therapeutic approach.
• Treatments included mucolytics, inhaled corticosteroids, a beta-2 agonist, hypertonic sodium chloride, and chest physiotherapy.

Implications:

• This case highlights the potential for plastic bronchitis to occur years after a Fontan procedure.
• The described treatment regimen resulted in partial recovery, suggesting a viable management strategy for this rare complication.
• Further research into the pathophysiology and long-term management of post-Fontan plastic bronchitis is warranted.