Percutaneous catheter aspiration thrombectomy may be a viable, less invasive option for treating acute thrombus in children with single ventricle physiology after Fontan surgery.
May support aspiration thrombectomy as a less invasive option in pediatric Fontan thrombus; hypothesis-generating and requires prospective validation.
Successful surgical palliation with the Fontan procedure allows survival into adulthood for many patients born with single ventricle (SV) physiology, but the limited studies reported incidence of perioperative and long-term complications including thromboembolic events. Chronic pulmonary embolism is a common complication in patients with Fontan circulation, and may have serious consequences. Percutaneous intervention may be less invasive option for such a high-risk population than surgery is. We described two patients who developed complete thrombosis of the left pulmonary artery following catheter placement of a stent in this vessel shortly after Fontan surgery. Percutaneous catheter aspiration thrombectomy was successfully performed. Percutaneous catheter aspiration thrombectomy may be considered as a viable option in acute thrombus in children with SV physiology after Fontan surgery.
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Hirono et al. (2014) studied this question.
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