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Transcatheter Treatment of Thrombosis in the Single Ventricle Pathway: An Institutional Experience

Yaser A Diab1, Karthik Ramakrishnan2, Fahad A Alfares2

  • 1Department of Hematology, Children's National Health System, Washington, DC, USA.

Congenital Heart Disease
|October 20, 2015
PubMed

Insights

Catheter-based interventions effectively treat shunt or conduit thrombosis in single ventricle patients. This approach safely restores blood flow and improves clinical status in children with complex congenital heart disease.

Area of Science:

  • Pediatric Cardiology
  • Interventional Cardiology
  • Congenital Heart Disease

Background:

  • Shunt or conduit thrombosis is a critical complication in single ventricle (SV) physiology.
  • Prompt restoration of shunt/conduit patency is essential for patient survival.
  • Transcatheter interventions offer a less invasive alternative to surgery or thrombolysis.

Purpose of the Study:

  • To evaluate the safety and efficacy of catheter-based interventions for shunt/conduit thrombosis in palliated single ventricle patients.
  • To describe the types of interventions used and their outcomes.
  • To assess the incidence of complications and thrombophilia.

Main Methods:

  • Retrospective review of patients with palliated single ventricle physiology and shunt/conduit thrombosis over a 5-year period.
  • Inclusion of patients who underwent catheter-based interventions.
  • Follow-up until hospital discharge.

Main Results:

  • Thirteen patients with thrombosis of modified Blalock-Taussig shunt, bidirectional cavopulmonary shunt, or total cavopulmonary pathway were identified.
  • Catheter interventions included balloon angioplasty, stent implantation, and mechanical thrombectomy.
  • Technical and clinical success was achieved in 12 patients, with 7 patients found to have thrombophilia.

Conclusions:

  • Percutaneous catheter-based interventions are safe and effective for managing shunt/conduit thrombosis in pediatric patients with single ventricle circulation.
  • These minimally invasive procedures can successfully restore shunt flow and improve patient condition.
  • The findings support catheter-based treatment as a valuable option for this high-risk population.
Abstract

Keywords:
Congenital Heart DiseaseSingle Ventricle PhysiologyTranscatheter Intervention

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