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Clinical Manifestations:

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Plastic bronchitis after extracardiac Fontan operation.

Giorgia Grutter1, Duccio Di Carlo, Fabrizio Gandolfo

  • 1Department of Cardiology and Cardiac Surgery, Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Pediatrico Bambino Gesù, Rome, Italy. giorgia.grutter@opbg.net

The Annals of Thoracic Surgery
|June 16, 2012
PubMed
Summary
This summary is machine-generated.

Plastic bronchitis (PB) after Fontan procedure is rare but serious. Early diagnosis and a combination therapy including steroids, mucolytics, and vasodilators may improve outcomes for this condition.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Pediatric Surgery

Background:

  • Plastic bronchitis (PB) is an uncommon condition characterized by the formation of bronchial casts.
  • It can occur after the Fontan procedure, a complex surgery for congenital heart defects.

Purpose of the Study:

  • To identify effective treatments for plastic bronchitis (PB) post-Fontan procedure.
  • To explore potential factors contributing to the development of PB in these patients.

Main Methods:

  • Retrospective analysis of four cases of PB following Fontan procedure.
  • Review of treatments including steroids, mucolytics, bronchoscopic interventions, and vasodilators.

Main Results:

  • All patients had undergone embolization of systemic-pulmonary collaterals and experienced chylothorax.
  • Two patients experienced fatal outcomes due to thrombosis and acute respiratory/cardiac failure.

Conclusions:

  • The precise etiology of PB in Fontan patients remains unclear.
  • A multi-modal therapeutic approach involving steroids, mucolytics, pulmonary vasodilators, and tissue plasminogen activator may be beneficial.