Cor Vasa 2021, 63(3):390-394 | DOI: 10.33678/cor.2020.116

A unique case of embolic myocardial infarction in a 22-year-old woman with Fontan circulation

Marianna Vachalcováa, Marta Jakubováb, Martin Czernyc, Alžbeta Bánovčinovád, Silvia Mišíkováb, Allan Böhme, Karolina Angela Sieradzkaf, Pavol Törökg, Gabriel Valočika, Ingrid Schusterováf
a Department of Cardiology, East-Slovak Institute of Cardiovascular Diseases, Košice, Slovak Republic
b Department of Arrhythmias, East-Slovak Insititute of Cardiovascular Diseases, Košice, Slovak Republic
c Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany
d Department of Paediatrics and Adolescent Medicine, Faculty of Medicine, Pavol Jozef Safarik University in Košice, Slovak Republic
e National Institute of Cardiovascular Diseases, Bratislava, Slovak Republic
f Department of Functional Diagnostics, East-Slovak Institute of Cardiovascular Diseases, Košice, Slovak Republic
g Clinic of Anesthesiology, East-Slovak Institute of Cardiovascular Diseases, Košice, Slovak Republic

Coronary artery embolism is an uncommon cause of acute myocardial infarction. We present a case of a 22-year-old patient with double inlet left ventricle (DILV), ventricular septal defect and pulmonary stenosis after Fontan repair with an acute embolic inferior ST-segment elevation myocardial infarction (STEMI). Apart from already known risk factors of thrombotic complications associated with Fontan circulation, additional predispositions in this patient included thrombus formation located in the inferior vena cava and the lack of anticoagulation therapy. This is one of the first reported embolic causes of STEMI in a patient with a Fontan circulation. Up to date, there is no consensus that anticoagulation therapy with warfarin is superior to aspirin in primary prevention of thromboembolism in patients with Fontan circulation.

Keywords: Anticoagulation therapy, Fontan circulation, Myocardial infarction, Trombembolic event

Received: November 21, 2020; Revised: December 15, 2020; Accepted: December 16, 2020; Published: July 20, 2021  Show citation

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Vachalcová M, Jakubová M, Czerny M, Bánovčinová A, Mišíková S, Böhm A, et al.. A unique case of embolic myocardial infarction in a 22-year-old woman with Fontan circulation. Cor Vasa. 2021;63(3):390-394. doi: 10.33678/cor.2020.116.
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