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The utility of computed tomographic angiography in a neonate on extracorporeal membrane oxygenation with extreme cyanosis after Blalock–Taussig shunt


1 Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
2 Department of Surgery, Division of Pediatric Cardiac Surgery, Medical University of South Carolina, Charleston, SC, USA
3 Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina; Department of Medicine, Medical University of South Carolina; Department of Pediatrics, Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA
4 Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina; Department of Pediatrics, Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA

Correspondence Address:
Anthony Marcus Hlavacek
Division of Pediatric Cardiology, Medical University of South Carolina, 165 Ashley Avenue, MSC 915, Charleston, SC 29425-9150
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2069.205137

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Year : 2017  |  Volume : 10  |  Issue : 2  |  Page : 209-211

 

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A modified Blalock–Taussig shunt (mBTS) is often employed to provide pulmonary blood flow in neonates that are born with cyanotic congenital heart defects. However, acute shunt thrombosis can occur in the postoperative period, resulting in profound cyanosis. In this case report, we describe the utility of computed tomographic angiography (CTA) in the management of a neonate with extreme cyanosis after placement of a mBTS while on extracorporeal membrane oxygenation. Using CTA, several small clots were identified in the shunt as well as stenosis of the left pulmonary artery; neither of which were identified with echocardiography. The CTA allowed for quick identification of the disorder and helped direct prompt surgical intervention.






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1 Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina, Charleston, SC, USA
2 Department of Surgery, Division of Pediatric Cardiac Surgery, Medical University of South Carolina, Charleston, SC, USA
3 Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina; Department of Medicine, Medical University of South Carolina; Department of Pediatrics, Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA
4 Department of Radiology and Radiological Science, Division of Cardiovascular Imaging, Medical University of South Carolina; Department of Pediatrics, Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, USA

Correspondence Address:
Anthony Marcus Hlavacek
Division of Pediatric Cardiology, Medical University of South Carolina, 165 Ashley Avenue, MSC 915, Charleston, SC 29425-9150
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2069.205137

Rights and Permissions

A modified Blalock–Taussig shunt (mBTS) is often employed to provide pulmonary blood flow in neonates that are born with cyanotic congenital heart defects. However, acute shunt thrombosis can occur in the postoperative period, resulting in profound cyanosis. In this case report, we describe the utility of computed tomographic angiography (CTA) in the management of a neonate with extreme cyanosis after placement of a mBTS while on extracorporeal membrane oxygenation. Using CTA, several small clots were identified in the shunt as well as stenosis of the left pulmonary artery; neither of which were identified with echocardiography. The CTA allowed for quick identification of the disorder and helped direct prompt surgical intervention.






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