Repair of a pseudoaneurysm during pulmonary valve replacement resolved chronic thrombocytopenia in a patient with Shone's complex, highlighting a mechanical cause for the condition.
May warrant checking residual RVOT defects before labeling ACHD thrombocytopenia as ITP; leaves open how often this mimic occurs.
We report the case of a 21-year-old patient who had long been incorrectly diagnosed as having treatment-resistant idiopathic thrombocytopenic purpura with chronic thrombocytopenia.The patient had Shone's complex and underwent multiple cardiac surgeries including the Ross-Konno procedure in her childhood.At the ages of 12 and 21 years, she underwent pulmonary valve replacement for pulmonary valve deterioration.In her last surgery, a small defect was found between the pulmonary artery and the reconstructed right ventricular outflow tract.A pseudoaneurysm developed because of the small defect, which was successfully repaired.Since then, her thrombocytopenia has improved spontaneously.
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Harada et al. (2025) studied this question.
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