Transcatheter Management of Native Aortic Root Thrombus After Fontan Palliation in a Pediatric Patient With COVID-19.

BACKGROUND

Primary native aortic root thrombus is a rare complication after single-ventricle palliation.

CASE SUMMARY: We describe a case of a pediatric patient with a single ventricle who developed a native aortic root thrombus and coronary artery thrombi after undergoing Fontan palliation and following COVID-19 infection. This report describes the transcatheter techniques employed to manage the thrombi, as well as the management of an unexpected complication involving thrombus embolization to the left common iliac artery.

DISCUSSION: Native aortic root thrombus and coronary artery thrombi in single-ventricle patients are potentially fatal events that require urgent intervention. Transcatheter procedures for thrombus resolution are inherently high risk and demand meticulous risk-reduction strategies.

TAKE-HOME MESSAGES: Risk of thrombotic complications may be higher in Fontan patients with COVID-19 infection. Timely use of high-risk procedural strategies in a single-ventricle patient with intracardiac and coronary artery thrombosis may be necessary to avoid lethal complications.