Intracardiac Thrombosis Involving All Four Cardiac Chambers after Extracardiac Membranous Oxygenation Associated with MTHFR Mutations.
A 4-month-old boy diagnosed with acute myocarditis was treated with extracorporeal membrane oxygenation (ECMO). Follow-up echocardiography eight hours after ECMO revealed intracardiac thrombosis involving all four heart chambers. Because of the high risk of systemic embolization due to a pedunculated thrombus of the aortic valve, we performed an emergency thrombectomy. After the operation, the patient had a minor neurologic sequela of left upper arm hypertonia, which had almost disappeared at the last outpatient clinic two months later. He was diagnosed with a major mutation in MTHFR (methylenetetrahydrofolate reductase), which is related to thrombosis.
Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Yonsei University College of Medicine.
Bong Jun
BJ
Kim
Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Yonsei University College of Medicine.
Seung Hwan
SH
Song
Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Yonsei University College of Medicine.
Yu Rim
YR
Shin
Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Yonsei University College of Medicine.
Han Ki
HK
Park
Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Yonsei University College of Medicine.
Young Hwan
YH
Park
Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Yonsei University College of Medicine; Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital, College of Medicine, Chungbuk National University.
Hong Ju
HJ
Shin
Extracorporeal membrane oxygenation; Methylenetetrahydrofolate reductase; Myocarditis; Thrombosis