Key result
Medical management with chronic anticoagulation successfully reduced thrombus size in 2 of 4 children with HLHS and native aortic root thrombus, whereas surgical thrombectomy resulted in death.
Why the study?
Thrombus formation in the native aortic root in patients with hypoplastic left heart syndrome is rarely reported, with only two cases previously described.
Case Report (n=4)
Medical management with chronic anticoagulation appears to be a viable and potentially safer strategy for managing native aortic root thrombosis in children with HLHS compared to surgical or thrombolytic interventions.
We present four children with hypoplastic left heart syndrome (HLHS) and development of thrombus in the native aortic root. There are only two previously reported cases in the literature. In all four of our patients, thrombus was noted on transthoracic echocardiography. In one patient, surgical thrombectomy was performed, with subsequent deterioration and death. Thrombolysis was used in one patient, with suspected embolic events following his treatment. In the remaining two patients, medical management with chronic anticoagulation was successful in reducing the size of the thrombus.
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Janssen et al. (2007) conducted a case report in Hypoplastic left heart syndrome (HLHS) with thrombus in the native aortic root (n=4). Surgical thrombectomy, thrombolysis, or chronic anticoagulation was evaluated on Clinical outcomes (thrombus reduction, embolic events, death). Medical management with chronic anticoagulation successfully reduced thrombus size in 2 of 4 children with HLHS and native aortic root thrombus, whereas surgical thrombectomy resulted in death.
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