Percutaneous coronary intervention following Fontan procedure

Subahi A, Forbes T, Ali OE.

Int J Cardiol Heart Vasc. 2020 Apr 8;28:100511. doi: 10.1016/j.ijcha.2020.100511. eCollection 2020 Jun.

PMID: 32300638 Free PMC Article

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Abstract

Fontan procedure is known to increase the risk of thromboembolic events. However, coronary artery thrombotic occlusion is rarely reported in patients with Fontan procedure. We present a case of a 10-year-old boy with hypoplastic left heart syndrome palliated with a Fontan procedure who presented with myocardial infarction secondary to thrombotic occlusion of the left circumflex coronary artery. He underwent successful percutaneous coronary intervention with thrombus aspiration, balloon angioplasty, and stent placement, highlighting the necessity of collaboration between congenital and adult cardiologists to treat acute coronary syndrome among this challenging young population.

 

Fig. 1 Coronary angiogram showing occlusion of proximal LCX coronary artery (yellow arrow). (LAD: left anterior descending artery. LCX: left circumflex artery. RCA: right coronary artery.

Fig. 2 Post‐aspiration angiography showing complete thrombus resolution, the LCX flow improved significantly. (LAD: left anterior descending artery. LCX: left circumflex artery. RCA: right coronary artery.

Fig. 3 Coronary angiogram showing significant stenosis in the proximal LCX coronary artery (yellow arrow). (LAD: left anterior descending artery. LCX: left circumflex artery. RCA: right coronary artery.

Fig. 4 Final angiography showing significant improvement of flow in the LCX with proximal drug-eluting Onyx 2.5 mm × 15 mm resolute stent (yellow arrow).

 

source:https://pubmed.ncbi.nlm.nih.gov/32300638/

 

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