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Ann Thorac Surg 1988;45:335-336
© 1988 The Society of Thoracic Surgeons

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Articles

Embolectomy for Acute Pulmonary Artery Occlusion Following Fontan Procedure

From the Divisions of Thoracic Surgery and Pediatric Cardiology, the University of Michigan Medical Center, Ann Arbor, MI

Accepted for publication July 27, 1987.

^* Address reprint requests to Dr. Bove, Section of Thoracic Surgery, The University of Michigan Medical Center, 2120 Taubman Health Care Center, Box 0344, 1500 E. Medical Center Dr, Ann Arbor, MI 48109-0344

A 5-year-old child experienced acute hemodynamic decompensation and hypoxia four weeks following an uneventful Fontan procedure for univentricular heart. Cardiac catheterization revealed complete occlusion of the left pulmonary artery, and emergent pulmonary artery embolectomy was performed. The source of the embolus was the atrial septal patch. Because of the altered hemodynamics following the Fontan procedure, stasis of right atrial blood and thrombus formation may occur. Routine anticoagulation immediately following operation is recommended. Prompt diagnosis and treatment with embolectomy may be lifesaving.

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