{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T23:24:09Z","timestamp":1772321049030,"version":"3.50.1"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The patient is a 15-year-old male with situs inversus, dextrocardia, bilateral superior caval veins, atrioventricular discordance with a single outlet, large perimembranous ventricular septal defect, aortic override, pulmonary atresia, and right aortic arch. The complex anatomy with a Ventricular Septal Defect (VSD) distant from the aorta (unsuitable for baffling to the aorta) meant he was unsuitable for biventricular repair and proceeded down a univentricular palliation pathway.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>Post-total cavopulmonary connection his clinical course was uneventful until the age of 5 when he developed fatigability with desaturation. An accessory hepatic vein was surgically banded with improved saturations and exercise tolerance. At the age of 15, cardiovascular magnetic resonance (CMR) was performed to investigate borderline saturations and as workup for transition to adult services. Cardiovascular magnetic resonance and cardiac computed tomography (CT) imaging demonstrated an eccentric thrombus causing stenosis of the extracardiac conduit and a thrombus outside of the lumen contained by the thin outer membrane of the Gore-Tex conduit. Collateralization suggested this was longstanding. Cardiac catheterization demonstrated a 4 mm \u00d7 6 mm stenosis at the junction of the conduit with the pulmonary arteries. The region was successfully balloon dilated and stented with a 34 mm-long Cheatham Platinum stent, with no complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>To date, this is the first documented case of a dissecting thrombus of a Gore-Tex graft in the literature. This case emphasizes the need for anticoagulation and serial cross-sectional imaging (CT or CMR) in Fontan patients with prosthetic grafts throughout a patients\u2019 lifetime.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab377","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T13:22:51Z","timestamp":1635254571000},"source":"Crossref","is-referenced-by-count":1,"title":["Case report of a Gore-Tex TCPC conduit dissection causing severe stenosis"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5029-1227","authenticated-orcid":false,"given":"Oliver","family":"Bates","sequence":"first","affiliation":[{"name":"Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3740-6429","authenticated-orcid":false,"given":"Thomas","family":"Semple","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6314-9350","authenticated-orcid":false,"given":"Sylvia","family":"Krupickova","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4946-9219","authenticated-orcid":false,"given":"Carles","family":"Bautista-Rodriguez","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,10,26]]},"reference":[{"key":"2021110408074823400_ytab377-B1","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/S0022-5223(19)35174-8","article-title":"Total cavopulmonary connection: a logical alternative to atriopulmonary connection for complex Fontan operations: experimental studies and early clinical experience","volume":"96","author":"de Leval","year":"1988","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021110408074823400_ytab377-B2","doi-asserted-by":"crossref","first-page":"1568","DOI":"10.1016\/j.jtcvs.2013.07.013","article-title":"High incidence of Dacron conduit stenosis for extracardiac Fontan procedure","volume":"147","author":"van Brakel","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021110408074823400_ytab377-B3","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.ejcts.2009.02.013","article-title":"Mid-term follow-up of the status of Gore-Tex graft after extracardiac conduit Fontan procedure","volume":"36","author":"Ochiai","year":"2009","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021110408074823400_ytab377-B4","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1111\/chd.12757","article-title":"Fate of the Fontan connection: mechanisms of stenosis and management","volume":"14","author":"Hagler","year":"2019","journal-title":"Congenit Heart Dis"},{"key":"2021110408074823400_ytab377-B5","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1177\/2150135118799625","article-title":"Late dissection of a Contegra conduit: a rare complication","volume":"10","author":"Ortega-Loubon","year":"2019","journal-title":"World J Pediatr Congenit Heart Surg"},{"key":"2021110408074823400_ytab377-B6","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.athoracsur.2010.02.032","article-title":"Acute dissection of a Contegra conduit: a rare mechanism of failure","volume":"90","author":"Kavarana","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"2021110408074823400_ytab377-B7","doi-asserted-by":"crossref","first-page":"472","DOI":"10.4103\/0971-3026.195783","article-title":"Dacron graft aneurysm with dissection","volume":"26","author":"Ali","year":"2016","journal-title":"Indian J Radiol Imaging"},{"key":"2021110408074823400_ytab377-B8","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1016\/j.athoracsur.2014.04.135","article-title":"Fatal spontaneous dissection of a Contegra conduit in a child","volume":"99","author":"Weldin","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"2021110408074823400_ytab377-B9","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1177\/2150135115592035","article-title":"A case report of Contegra conduit dissection with subsequent heart failure","volume":"7","author":"Buelow","year":"2016","journal-title":"World J Pediatr Congenit Heart Surg"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytab377\/40863819\/ytab377.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/11\/ytab377\/41074764\/ytab377.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/11\/ytab377\/41074764\/ytab377.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T08:08:02Z","timestamp":1636013282000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytab377\/6410644"}},"subtitle":[],"editor":[{"given":"Mohammed","family":"Al-Hijji","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Luis Antonio","family":"Moreno-Ru\u00edz","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Flemming","family":"Javier Olsen","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Rahul","family":"Mukherjee","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Fabienne","family":"Vervaat","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,10,26]]},"references-count":9,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytab377","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,11,1]]},"published":{"date-parts":[[2021,10,26]]},"article-number":"ytab377"}}