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Pulmonary thromboembolism after one and a half ventricle repair

Successful catheter-directed thrombolysis
  • Koji Nomura
  • Hiromi Kurosawa
  • Kiyozo Morita
  • Kei Tanaka
  • Shogo Shimizu
Article

Abstract

Acute pulmonary thromboembolism in a patient who had undergone bidirectional Glenn anastomosis was treated by percutaneous selective intravascular thrombolysis. A 20-year-old woman was diagnosed with pulmonary stenosis and right ventricular hypoplasia, complete occlusion of the left pulmonary artery secondary to a Blalock-Taussig shunt, and atrial septal defect. The patient developed thromboembolism of the subsegmental branches of the right pulmonary artery resulting in critical hemodynamic deterioration 2 weeks after undergoing one and a half ventricle repair (bidirectional Glenn shunt). The patient was treated with tissue plasminogen activator administered directly into the right pulmonary artery via an intravascular cathe. Progressive recanalization of the obstruction began immediately. Pulmonary angiography 3 months after thrombolytic therapy demonstrated patent subsegmental vessels. Early detection of the pulmonary thromboembolism and prompt intervention are crutial to relieving this fatal complication after a Fontan operation.

Key words

one and a half ventricle repair acute pulmonary thromboembolism cather-directed thrombolysis Fontan circulation 

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Copyright information

© Japanese Association for Thoracic Surgery 2001

Authors and Affiliations

  • Koji Nomura
    • 1
  • Hiromi Kurosawa
    • 1
  • Kiyozo Morita
    • 1
  • Kei Tanaka
    • 1
  • Shogo Shimizu
    • 1
  1. 1.Department of Cardiovascular SurgeryJikei University School of MedicineTokyoJapan

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