Repeated aortopulmonary shunt thrombosis in a neonatal patient with a low antithrombin level. World J Pediatr Congenit Heart Surg 2014 Jan 01;5(1):94-6
Date
01/10/2014Pubmed ID
24403363DOI
10.1177/2150135113504309Scopus ID
2-s2.0-84907663865 (requires institutional sign-in at Scopus site) 1 CitationAbstract
A female infant with unbalanced right ventricular dominant atrioventricular septal defect with double-outlet right ventricle and pulmonary stenosis had recurrent aortopulmonary shunt thrombosis. She was found to have low antithrombin levels and was managed with antithrombin replacement in addition to unfractionated heparin. A subsequent aortopulmonary shunt was successfully placed, and patency was maintained. Her antithrombin levels normalized, and she was continued on low-molecular-weight heparin and aspirin until four months of age when a bidirectional superior cavopulmonary anastomosis was done. A prothrombotic evaluation at the time of the acute thrombosis and repeated at four months of age was negative except for the initially low antithrombin level. A repeat antithrombin level (off supplementation) at the time of the cavopulmonary anastomosis was normal making the diagnosis of congenital antithrombin deficiency unlikely. This case highlights the possibility of neonatal antithrombin deficiency as a cause of aortopulmonary shunt thrombosis and successful management with replacement therapy.
Author List
Niebler RA, Mitchell ME, Scott JPAuthors
Michael Edward Mitchell MD Chief, Professor in the Surgery department at Medical College of WisconsinRobert Niebler MD Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Abnormalities, MultipleAnticoagulants
Antithrombins
Biomarkers
Double Outlet Right Ventricle
Female
Heart Bypass, Right
Heart Septal Defects
Humans
Infant, Low Birth Weight
Infant, Newborn
Pulmonary Valve Stenosis
Secondary Prevention
Thrombosis
Treatment Outcome
Ultrasonography, Prenatal
