Mechanical thrombectomy of COVID-19 DVT with congenital heart disease leading to phlegmasia cerulea dolens: a case report

Neema Jamshidi, Weiyi Tan, Dingle Foote, Leigh Reardon, Gentian Lluri, Jamil Aboulhosn, John Moriarty, Jeannette Lin

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: COVID-19 and Fontan physiology have each been associated with an elevated risk of venous thromboembolism (VTE), however little is known about the risks and potential consequences of having both. Case presentation: A 51 year old male with tricuspid atresia status post Fontan and extracardiac Glenn shunt, atrial flutter, and sinus sick syndrome presented with phlegmasia cerulea dolens (PCD) of the left lower extremity in spite of supratherapeutic INR in the context of symptomatic COVID-10 pneumonia. He was treated with single session, catheter directed mechanical thrombectomy that was well-tolerated. Conclusions: This report of acute PCD despite therapeutic anticoagulation with a Vitamin K antagonist, managed with emergent mechanical thrombectomy, calls to attention the importance of altered flow dynamics in COVID positive patients with Fontan circulation that may compound these independent risk factors for developing deep venous thrombosis with the potential for even higher morbidity.

Original languageEnglish (US)
Article number592
JournalBMC Cardiovascular Disorders
Volume21
Issue number1
DOIs
StatePublished - Dec 2021
Externally publishedYes

Keywords

  • Case report
  • ClotTriever
  • Femoral and iliac vein thrombosis
  • Fontan
  • Mechanical thrombectomy
  • Venous thromboembolism

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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