title: Transcatheter pulmonary embolectomy after fontan.
abstract: Pulmonary embolism (PE) is a significant cause of morbidity and mortality among hospitalized patients, and thrombolytics are the mainstay of treatment. However, for patients who fail or have contraindications to thrombolytic therapy, catheter-based therapies, such as the AngioVac aspiration system, have emerged as an alternative to surgical embolectomy. Here, we present the novel case of a 22 year-old woman with Fontan circulation who developed severe postpartum cardiomyopathy and a saddle PE. She failed thrombolytic therapy but underwent successful pulmonary embolectomy by AngioVac aspiration. Patients with Fontan circulation have an increased incidence of thromboembolic events, and AngioVac thrombectomy is a valuable treatment option in these complex patients.
authors.affiliation: Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina.|Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.
authors.forename: Rachel D
authors.initials: RD
authors.lastname: Torok
authors.affiliation: Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina.|Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Fleming
authors.affiliation: Division of Pediatric Cardiology, Duke University Medical Center, Durham, North Carolina.|Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Hill
mesh_terms: D017128:Embolectomy / Q000379:methods*; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects*; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D012307:Risk Factors; D013396:Suction; D016896:Treatment Outcome; D055815:Young Adult
keywords: congenital heart disease; heart failure; pulmonary embolism; thrombectomy