Intraoperative thrombus formation in the artificial tube graft in a fenestrated extracardiac Fontan procedure-to trust our eyes or instincts?

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Indian Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-01-01 Epub Date: 2024-08-28 DOI:10.1007/s12055-024-01821-7

Varikkara Krishna Narayanan Nayanar, Nithin Krishna Vikraman, Greeshma Sudarsanan, Mamatha Munaf

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Abstract

Appearance of a thrombus in the graft intraoperatively during Fontan surgery is not reported and warrants careful evaluation. Our patient was an 18-year-old lady who underwent fenestrated extracardiac Fontan surgery. Intraoperatively, transesophageal echocardiography revealed an echogenic structure inside the conduit. Whether it was an artifact or a thrombus was debated and ruled in favor of an echocardiographic artifact owing greatly to the absence of any reported cases of intraoperative Fontan conduit thrombus. The patient had an uneventful recovery though as a team we are convinced that it is most likely a thrombus, in retrospect. The absence of similar cases in literature and the significant potential consequences of the event make this case worthy of discussion.

Supplementary information: The online version contains supplementary material available at 10.1007/s12055-024-01821-7.

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心外方坦手术中人工管道移植的术中血栓形成--相信我们的眼睛还是直觉？

在丰坦手术中，术中出现移植物血栓的情况尚未见报道，因此需要仔细评估。我们的患者是一名 18 岁的女性，她接受了心外丰坦手术。术中，经食道超声心动图显示导管内有回声结构。由于没有任何关于术中丰坦导管血栓的病例报道，因此大家对该结构是伪影还是血栓进行了讨论，并倾向于认为是超声心动图伪影。尽管作为一个团队，我们确信这很可能是一个血栓，但患者恢复顺利。文献中没有类似病例，而且该事件可能造成严重后果，因此该病例值得讨论：在线版本包含补充材料，可在 10.1007/s12055-024-01821-7 上查阅。

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来源期刊

Indian Journal of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

1.20

自引率

14.30%

发文量

141

期刊介绍： The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.