title: Systemic thromboembolism leading to myocardial infarction and stroke after fenestrated total cavopulmonary connection.
abstract: Thromboembolic phenomena involving the caval veins, right atrium, and pulmonary artery are recognised complications after the Fontan operation and other forms of total cavopulmonary connection. A rare case of systemic thromboembolism is reported in a 3 year old girl who had repeated coronary and cerebral thromboembolic events after a fenestrated total cavopulmonary shunt operation. A survey of the 18 paediatric cardiac units in the United Kingdom and Ireland showed a wide discrepancy in anticoagulation policies after Fontan-type operations. Prevention of thrombotic complications by lifelong postoperative anticoagulation may outweigh the risk of haemorrhage.
authors.affiliation: Congenital Heart Disease Research Unit, University Hospital of Wales, Heath Park, Cardiff.
authors.forename: D G
authors.initials: DG
authors.lastname: Wilson
authors.forename: J D
authors.initials: JD
authors.lastname: Wisheart
authors.forename: A G
authors.initials: AG
authors.lastname: Stuart
mesh_terms: D001241:Aspirin / Q000008:administration & dosage; D002561:Cerebrovascular Disorders / Q000209:etiology*; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D018729:Fontan Procedure; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology*; D011183:Postoperative Complications / Q000517:prevention & control; D013923:Thromboembolism / Q000150:complications* / Q000517:prevention & control; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D014859:Warfarin; D001241:Aspirin