BMC cardiovascular disorders · 2021
Mechanical thrombectomy of COVID-19 DVT with congenital heart disease leading to phlegmasia cerulea dolens: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Jamshidi Neema, Tan Weiyi, Foote Dingle, Reardon Leigh, Lluri Gentian, Aboulhosn Jamil, Moriarty John, Lin Jeannette
Аннотация
BACKGROUND: COVID-19 and Fontan physiology have each been associated with an elevated risk of venous thromboembolism (VTE), however little is known about the risks and potential consequences of having both.
CASE PRESENTATION: A 51 year old male with tricuspid atresia status post Fontan and extracardiac Glenn shunt, atrial flutter, and sinus sick syndrome presented with phlegmasia cerulea dolens (PCD) of the left lower extremity in spite of supratherapeutic INR in the context of symptomatic COVID-10 pneumonia. He was treated with single session, catheter directed mechanical thrombectomy that was well-tolerated.
CONCLUSIONS: This report of acute PCD despite therapeutic anticoagulation with a Vitamin K antagonist, managed with emergent mechanical thrombectomy, calls to attention the importance of altered flow dynamics in COVID positive patients with Fontan circulation that may compound these independent risk factors for developing deep venous thrombosis with the potential for even higher morbidity.
CASE PRESENTATION: A 51 year old male with tricuspid atresia status post Fontan and extracardiac Glenn shunt, atrial flutter, and sinus sick syndrome presented with phlegmasia cerulea dolens (PCD) of the left lower extremity in spite of supratherapeutic INR in the context of symptomatic COVID-10 pneumonia. He was treated with single session, catheter directed mechanical thrombectomy that was well-tolerated.
CONCLUSIONS: This report of acute PCD despite therapeutic anticoagulation with a Vitamin K antagonist, managed with emergent mechanical thrombectomy, calls to attention the importance of altered flow dynamics in COVID positive patients with Fontan circulation that may compound these independent risk factors for developing deep venous thrombosis with the potential for even higher morbidity.
Предметные рубрики MeSH
Amputation, SurgicalAtrial FlutterCOVID-19Fontan ProcedureGangreneHeart Defects, CongenitalHumansImage Processing, Computer-AssistedLower ExtremityMaleMechanical ThrombolysisMiddle AgedPhlebographyPostoperative ComplicationsSick Sinus SyndromeThrombophlebitisTomography, X-Ray ComputedTreatment OutcomeTricuspid AtresiaWarfarin