Intracardiac right-to-left shunting and the risk of stroke during bone marrow infusion.
We describe a patient who developed a paradoxical embolus to the brain during infusion of bone marrow. She had a patent foramen ovale through which right-to-left shunting led to multiple cerebral emboli. This complication can be prevented by positioning the tip of the infusion catheter in the main pulmonary artery and reducing the volume of marrow product infused.
Moore
T B
TB
Division of Pediatric Hematology/Oncology, UCLA School of Medicine, USA.
Chow
V J
VJ
Ferry
D
D
Feig
S A
SA
D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002897:Chromosomes, Human, Pair 7; D004314:Down Syndrome / Q000150:complications; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology* / Q000517:prevention & control; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000628:therapy; D009006:Monosomy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000628:therapy; D012307:Risk Factors; D014463:Ultrasonography