Cerebellar infarct: late complication of the Fontan procedure?

Cardiac disease is present in approximately 30% of children with stroke. Other case reports have documented stroke in patients who have previously undergone the Fontan procedure for correction of tricuspid atresia. Most of these strokes have occurred in the immediate postoperative period. There has been one report of a cerebral infarction 3 1/2 months after surgery. We report a child with superior cerebellar artery distribution infarction after undergoing the Fontan procedure 24 months previously. Previous reports of stroke in patients having undergone the Fontan procedure and possible etiologies for these strokes are discussed. We believe our patient had the longest procedure-to-stroke interim yet reported.