Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-28T21:21:58.826Z Has data issue: false hasContentIssue false

Resolution of intracardiac thrombus with novel oral anticoagulants in an adult patient with complex CHD

Published online by Cambridge University Press:  02 May 2017

Giancarlo Scognamiglio*
Affiliation:
Paediatric Cardiology and G.U.C.H. Unit, A.O.R.N. “Ospedali dei Colli”, Second University of Naples, Naples, Italy
Rosaria Barracano
Affiliation:
Paediatric Cardiology and G.U.C.H. Unit, A.O.R.N. “Ospedali dei Colli”, Second University of Naples, Naples, Italy
Berardo Sarubbi
Affiliation:
Paediatric Cardiology and G.U.C.H. Unit, A.O.R.N. “Ospedali dei Colli”, Second University of Naples, Naples, Italy
*
Correspondence to: Dr G. Scognamiglio, G.U.C.H. Unit – Division of Cardiology, Second University of Naples, AO Dei Colli Monaldi Hospital, Leonardo Bianchi Street 1, 80131 Naples, Italy. Tel: +39 081 706 2682; Fax: +39 081 881 9648; E-mail: giancascognamiglio@alice.it

Abstract

Thromboembolic complications occur frequently in Fontan patients with atrial arrhythmias and are a cause of significant morbidity and all-cause mortality. We report the case of an adult woman with direct atriopulmonary connection and atrial arrhythmia who developed a right atrial thrombus. She was switched to apixaban therapy because of echocardiographic evidence of thrombus progression despite combined therapy with warfarin and aspirin. After 1 year of treatment, there was evidence of complete thrombus resolution, in the absence of bleeding events. Our case shows that direct oral anticoagulants can be effective and safe for the treatment of thrombosis in adult patients with complex CHD.

Type
Brief Report
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Egbe, AC, Connolly, HM, McLeod, CJ, et al. Thrombotic and embolic complications associated with atrial arrhythmia after Fontan operation: role of prophylactic therapy. J Am Coll Cardiol 2016; 68: 13121319.Google Scholar
2. Odegard, KC, McGowan, FX Jr, Zurakowski, D, et al. Procoagulant and anticoagulant factor abnormalities following the Fontan procedure: increased factor VIII may predispose to thrombosis. J Thorac Cardiovasc Surg 2003; 125: 12601267.Google Scholar
3. Pujol, C, Niesert, AC, Engelhardt, A, et al. Usefulness of direct oral anticoagulants in adult congenital heart disease. Am J Cardiol 2016; 117: 450455.Google Scholar