Thrombosis prevention after Fontan procedure

Thrombosis prevention after Fontan procedure refers to thromboprophylaxis targeted at mitigating the elevated risk of venous and arterial thromboembolic complications in pediatric and adult patients with functionally univentricular congenital heart disease who have undergone palliative cavopulmonary reconstruction Defining pathophysiologic mechanisms include chronic low-velocity nonlaminar flow, venous stasis, elevated systemic venous pressures, the presence of prosthetic conduit material, hepat...

The Fontan circulation directly channels systemic venous return passively into the pulmonary arterial bed without a subpulmonic pump, creating abnormal hemodynamic conditions that foster thrombus formation Defining pathophysiologic mechanisms include chronic low-velocity nonlaminar flow, venous stasis, elevated systemic venous pressures, the presence of prosthetic conduit material, hepatic synthetic dysfunction leading to imbalances between procoagulant and anticoagulant factors, and chronic end...

Thromboembolic events in this postoperative state can precipitate acute hemodynamic collapse, conduit occlusion, pulmonary embolism, or paradoxical systemic embolization leading to ischemic stroke