Native Aortic Root Thrombus in 3-Year-Old Fontan Patient with Hypoplastic Left Heart Syndrome: Presentation and Echocardiographic Findings of This Life-Threatening Complication

Figures

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  Figure 1. Transthoracic echocardiogram in the parasternal long-axis view obtained on discharge after Fontan procedure demonstrates a diminutive left ventricle (LV) consistent with HLHS, a large right ventricle (RV), and the native ascending aorta (AAo). There is absence of thrombus in the left ventricle and in the native aortic root.

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  Figure 2. (A) Transthoracic echocardiogram in the parasternal long-axis view shows organized thrombus filling the hypoplastic left ventricle (LV) and separate thrombus in the native aortic root (large arrow). (B) Transthoracic echocardiogram in the parasternal short-axis view shows thrombus (large arrow) in the native aortic root near the ostium of the left main coronary artery. AAo, Ascending aorta; RA, right atrium; RV, right ventricle.

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  Figure 3. Intraoperative angiography shows a dilated proximal left coronary artery with severe tapering of the distal branches (small arrows) and a lack of anterograde flow to the proximal right coronary artery (large arrow). A diverticulum at the base of aortic valve is also appreciated. LMCA, Left main coronary artery.

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  Figure 4. Transthoracic echocardiogram in the parasternal short-axis view demonstrates patent left and right coronary arteries after the use of catheter-directed tPA. LMCA, Left main coronary artery; RCA, right coronary artery.