Intracardiac thrombus in adults with the Fontan circulation

• DOI: 10.1017/s104795110700145x
• Publication Date: 2007-10-24T09:26:42Z
• Authors: Wendy Tsang; Bengt Johansson; Omid Salehian; Johan Holm; Gary Webb; Michael A. Gatzoulis; Judith Therrien
• Keywords: Fontan Procedure; Circulation (fluid dynamics)

ObjectivesTo determine the treatment and outcomes of a cohort adults with Fontan circulation diagnosed intracardiac thrombus.BackgroundFormation thrombus is common after operation, albeit little has been published on these patients once they have developed an thrombus.MethodsWe identified all who had converted to from cardiology database at Toronto Congenital Cardiac Centre for Adults, Toronto, The Royal Brompton Hospital, London, studying period 1981 2003. We then reviewed relevant echocardiograms medical records.ResultsIntracardiac was in 28 235 circulation, having average age 27 plus or minus 9 years. Of patients, 21 were initially medically treated, 19 heparin warfarin, 2 thrombolysis, whereas 7 underwent immediate surgical removal clot. Overall mortality 18%, residual clots seen 39% surviving 1 year follow up. At presentation, haemodynamic stability each patient dictated initial strategies management, 17% those stable presentations undergoing treatment, as opposed 75% unstable (p-value equals 0.04), well correlating ultimate clinical outcome. rate death 8% haemodynamically versus (p value 0.01).ConclusionFormation not rare carries significant risk death, especially clinically patients. Emphasis prevention formation clot warranted.