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Left ventricular thrombus formation after repair of anomalous left coronary artery from the pulmonary artery.

ABSTRACT: Although thrombus formation following myocardial infarction in adults is well known, intracardiac thrombosis in children is uncommon. We report the case of a large left ventricular thrombus in an infant with ischemic cardiomyopathy secondary to anomalous origin of the left coronary artery from the pulmonary artery. Given its mobility and protrusion across the aortic valve, the patient underwent urgent thrombus removal through a transaortic approach. There were no embolic or neurologic complications. This case highlights that thrombectomy may be performed safely and successfully in critically ill pediatric patients.

SUBMITTER: Freud LR

PROVIDER: S-EPMC4275842 | biostudies-literature | 2014 Apr

REPOSITORIES: biostudies-literature

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Left ventricular thrombus formation after repair of anomalous left coronary artery from the pulmonary artery.

Freud Lindsay R LR Koenig Peter R PR Russell Hyde M HM Patel Angira A

World journal for pediatric & congenital heart surgery 20140401 2

Although thrombus formation following myocardial infarction in adults is well known, intracardiac thrombosis in children is uncommon. We report the case of a large left ventricular thrombus in an infant with ischemic cardiomyopathy secondary to anomalous origin of the left coronary artery from the pulmonary artery. Given its mobility and protrusion across the aortic valve, the patient underwent urgent thrombus removal through a transaortic approach. There were no embolic or neurologic complicati ...[more]

PMID: 24668990

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Project description:ObjectiveThe purpose of this study was to evaluate the prognosis of patients with anomalous left coronary artery originating from pulmonary artery with varying cardiac function after surgical correction.MethodsThis was a single-center retrospective cohort study including 51 patients with anomalous left coronary artery originating from pulmonary artery, all of whom underwent surgery at our center.ResultsAll 5 deaths occurred in the pre-operative low cardiac function group (n = 39). After corrected by body surface area, parameters such as left coronary artery, right coronary artery, left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and main pulmonary artery diameter, were lower in patients in the normal cardiac function group than in the low cardiac function group. The rate of collateral circulation formation was higher in the normal cardiac function group. The proportion of changes of T wave was higher in the low cardiac function group (P = 0.005), and the duration of vasoactive drugs (dopamine, milrinone, epinephrine, nitroglycerin.) was longer in the low cardiac function group. Left ventricular end-diastolic diameter, left ventricular end-systolic diameter, main pulmonary artery diameter, and left atrial diameter were smaller than those pre-operatively (P < 0.05). Left ventricular ejection fraction was higher than that pre-operatively (P = 0.003). The degree of mitral regurgitation in the low cardiac function group was reduced post-operatively (P < 0.001).ConclusionThere was a significant difference between the pre-operative baseline data of the low cardiac function group and the normal cardiac function group. After surgical repair, cardiac function gradually returned to normal in the low cardiac function group. The low cardiac function group required vasoactive drugs for a longer period of time. The left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left atrial diameter, and main pulmonary artery diameter decreased and gradually returned to normal after surgery. The degree of mitral regurgitation in the low cardiac function group was reduced after surgery.

Dataset Information

Left ventricular thrombus formation after repair of anomalous left coronary artery from the pulmonary artery.

Publications

Left ventricular thrombus formation after repair of anomalous left coronary artery from the pulmonary artery.

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