Abstract Background Thromboembolic complications remain a significant cause of morbidity following the Fontan procedure, driven by the unique hemodynamics of the Fontan circulation. Case Summary We present a case of a 14-year-old patient with single ventricle physiology who underwent an extracardiac Fontan procedure. Postoperatively, he developed low cardiac output requiring ECMO support. Despite successful weaning from ECMO, hepatomegaly, pleural effusion, and ascites persisted. Further investigation revealed a significant thrombus within the Fontan conduit. Due to the high risks associated with systemic thrombolysis and repeat cardiac surgery, these treatment options were not pursued. Instead, an innovative approach utilizing a device specifically engineered for thrombus extraction in the pulmonary arteries was used. The conduit thrombus was completely extracted without complications, and the patient recovered rapidly and was discharged two weeks later. Discussion This case highlights the potential complications following Fontan surgery and the importance of timely, tailored new therapeutic interventional procedures in fragile patients with complex congenital heart diseases.
Ferri-Rufete et al. (Wed,) studied this question.