Stroke following Glenn anastomosis in a child with inherited thrombophilia.
The optimal anticoagulation following Fontan operation and its modifications remain controversial and it is even less well defined as regards patients with inherited thrombophilia. We present a case of a child with bidirectional Glenn anastomosis for double inlet left ventricle that suffered a stroke despite aspirin prophylaxis; the patient was combined homozygous for prothrombin G20210A mutation and for methylenetetrahydrofolate reductase C677T mutation as well. The family history was positive for fetal loss and premature cardiovascular disease. Large-scale studies are needed to evaluate whether carriers of thrombophilia mutations need more intense thromboprophylaxis.
Germanakis
Ioannis
I
Sfyridaki
Caterina
C
Papadopoulou
Eleftheria
E
Raissaki
Maria
M
Rammos
Spyridon
S
Sarris
George
G
Kalmanti
Maria
M
D000714:Anastomosis, Surgical; D001241:Aspirin / Q000627:therapeutic use; D002545:Brain Ischemia / Q000209:etiology*; D002675:Child, Preschool; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D018610:Heart Bypass, Right / Q000009:adverse effects*; D006801:Humans; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D009154:Mutation; D011516:Prothrombin / Q000235:genetics; D019851:Thrombophilia / Q000235:genetics / Q000517:prevention & control / Q000601:surgery*
D005343:Fibrinolytic Agents; D011516:Prothrombin; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D001241:Aspirin