Thrombotic occlusion of Blalock-Taussig shunt in a patient with unnoticed protein C deficiency.
A 6-month-old girl with a diagnosis of double-outlet right ventricle and pulmonary stenosis had a left modified Blalock-Taussig shunt. Chest computed tomography (CT) performed on postoperative day 11 showed good patency of the shunt. However, on postoperative day 16, oxygen saturation suddenly dropped below 40%, and chest CT showed thrombotic occlusion of the shunt. Urgent thrombectomy was performed successfully. Examination of coagulation factors revealed low levels of both the amount and activity of protein C (27% and 31%, respectively). Diagnosis of heterozygous hereditary protein C deficiency was made, and the patient was placed on warfarin. She is currently in good condition.
Watanabe
Manabu
M
Unit of Cardiovascular Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, 1-1 Kanayama, Teine-ku, Sapporo, Hokkaido 006-0041, Japan. dookuman@beige.ocn.ne.jp
Aoki
Mitsuru
M
Fujiwara
Tadashi
T
D000925:Anticoagulants / Q000627:therapeutic use; D004310:Double Outlet Right Ventricle / Q000150:complications / Q000601:surgery*; D004630:Emergencies; D006801:Humans; D007223:Infant; D011183:Postoperative Complications; D020151:Protein C Deficiency / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011666:Pulmonary Valve Stenosis / Q000601:surgery; D013902:Radiography, Thoracic; D017131:Thrombectomy; D013927:Thrombosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin