Simultaneous Pulmonary Embolism and Ischemic Stroke in a Patient with Cor Biloculare after Glenn Anastomosis

Heart Surg Forum. 2019 May 8;22(3):E180-E182. doi: 10.1532/hsf.2054.

Abstract

Background: Cor biloculare, two-chambered heart due to the absence of atrial and ventricular septa, is a rare congenital heart anomaly. For Cor biloculare and other cardiac defects with single ventricle physiology, Glenn anastomosis has been developed as a palliative procedure. Thrombosis secondary to Glenn anastomosis in the patient with Cor biloculare could pose a serious threat to the survival, and has never been reported before.

Case report: We report the case of a 27-year-old patient, with past history of Glenn anastomosis that was performed 7 years ago for the palliation of Cor biloculare. She presented with pulmonary embolism and ischemic stroke simultaneously at 7 days after Cesarean section. Due to her critical status, systemic anticoagulation with low-molecular-weight heparin was started immediately, followed by lifelong warfarin therapy. Pulmonary embolism regressed and neurological symptoms were considerably diminished after the anticoagulation treatment.

Conclusion: This case illuminates the potential risk of thrombotic events in this patient cohort and demonstrates that anticoagulation therapy is an effective, secure, and appropriate for the management of this disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use
  • Brain Ischemia / diagnosis
  • Brain Ischemia / etiology*
  • Brain Ischemia / therapy
  • Cesarean Section
  • Female
  • Fontan Procedure / adverse effects*
  • Heart Defects, Congenital / complications
  • Heart Defects, Congenital / surgery*
  • Humans
  • Puerperal Disorders / diagnosis
  • Puerperal Disorders / etiology*
  • Puerperal Disorders / therapy
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / etiology*
  • Pulmonary Embolism / therapy
  • Stroke / diagnosis
  • Stroke / etiology*
  • Stroke / therapy

Substances

  • Anticoagulants