Korean J Thorac Cardiovasc Surg.  2016 Jun;49(3):207-209. 10.5090/kjtcs.2016.49.3.207.

Intracardiac Thrombosis Involving All Four Cardiac Chambers after Extracardiac Membranous Oxygenation Associated with MTHFR Mutations

Affiliations
  • 1Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea. babymedi@naver.com
  • 2Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Korea.

Abstract

A 4-month-old boy diagnosed with acute myocarditis was treated with extracorporeal membrane oxygenation (ECMO). Follow-up echocardiography eight hours after ECMO revealed intracardiac thrombosis involving all four heart chambers. Because of the high risk of systemic embolization due to a pedunculated thrombus of the aortic valve, we performed an emergency thrombectomy. After the operation, the patient had a minor neurologic sequela of left upper arm hypertonia, which had almost disappeared at the last outpatient clinic two months later. He was diagnosed with a major mutation in MTHFR (methylenetetrahydrofolate reductase), which is related to thrombosis.

Keyword

Myocarditis; Extracorporeal membrane oxygenation; Thrombosis; Methylenetetrahydrofolate reductase
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