Embolic myocardial infarction in a patient with a Fontan circulation.

Abstract

Coronary artery embolism is an uncommon cause of acute myocardial infarction (MI). We present a patient with pulmonary atresia and severe right heart hypoplasia who underwent a lateral tunnel Fontan procedure in childhood and presented with an acute ST-segment elevation MI at 19 years of age. In addition to the known risk of thrombotic complications associated with a Fontan circulation, potential predisposing factors to thromboembolism in this patient included a right ventricle to left anterior descending coronary connection and a Fontan baffle leak. The patient was treated with device closure of the baffle leak and anticoagulation. This is one of the first reports of an embolic MI in a patient with a Fontan circulation. The optimal method of reducing thromboembolic risk in this patient, and those with a Fontan circulation in general, is complicated and no consensus exists.

• Authors: Ramin S Hastings, Doff B McElhinney, Muhamed Saric, Calvin Ngai, Adam H Skolnick
• Journal: World journal for pediatric & congenital heart surgery (World J Pediatr Congenit Heart Surg) Vol. 5 Issue 4 Pg. 631-4 (Oct 2014) ISSN: 2150-136X [Electronic] United States
• PMID: 25324270 (Publication Type: Case Reports, Journal Article)
• Copyright: © The Author(s) 2014.

Topics

• Angioplasty, Balloon, Coronary
• Female
• Fontan Procedure (adverse effects)
• Heart Defects, Congenital (complications, surgery)
• Heart Ventricles (abnormalities, surgery)
• Humans
• Myocardial Infarction (drug therapy, etiology, surgery)
• Pulmonary Atresia (complications, surgery)
• Thrombectomy
• Thromboembolism (etiology, surgery)
• Young Adult