Extracardiac Conduit Subocclusion in an Adult Patient With a Fontan Circulation
Emanuela C D'Angelo1, Rosalinda Palmieri1, Veronica Lisignoli1
1Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
JACC. Case Reports
|April 4, 2025
Summary
Extracardiac conduit obstruction can cause Fontan failure. Multimodality imaging is crucial for diagnosing calcific masses in Fontan patients presenting with heart failure symptoms.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Cardiac Surgery
Background:
- Fontan circulation is a complex surgical repair for single-ventricle congenital heart defects.
- Conduit obstruction is a known complication that can lead to Fontan failure.
Observation:
- A Fontan patient presented with exertional dyspnea and peripheral edema, indicative of heart failure.
- Echocardiography revealed a hyperechogenic mass within the extracardiac conduit.
Findings:
- Computed tomography and cardiac MRI confirmed severe conduit obstruction due to a calcific mass.
- Extensive collateral circulation was identified, suggesting chronic obstruction.
Implications:
- Prompt diagnosis and surgical intervention are vital for managing Fontan failure.
- Multimodality imaging is essential for accurate assessment and surgical planning in Fontan patients.
- Suspecting conduit obstruction in Fontan patients with heart failure symptoms is critical.
