{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T07:11:34Z","timestamp":1776409894251,"version":"3.51.2"},"reference-count":4,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Right ventricle outflow tract (RVOT) dysfunction is a common long-term complication in adult patients with pulmonary atresia\/ventricular septal defect (PA\/VSD). Common causes include valve thrombosis, stent fractures, and graft calcification. We present, to the best of our knowledge, the first case of malignant invasion of a Gore-Tex conduit, causing severe right ventricle (RV) failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 30-year-old woman with a history of PA\/VSD with major aortopulmonary collateral arteries (MAPCAs) presented with worsening dyspnoea and exercise intolerance. In infancy, she underwent unifocalization of the right- and left-sided AP collaterals utilizing an 18 and 16 mm Gore-Tex graft, respectively. At age 7, she had surgical repair with VSD patch closure and placement of a 20 mm right ventricle-pulmonary artery (RVPA) homograft connected to a 20 mm Gore-Tex graft with linkage to the previously placed right and left unifocalization grafts. A transthoracic echocardiogram revealed a severely dilated RV and a heavily calcified RVOT conduit with severe stenosis. Cardiac computed tomography showed a stenotic RVPA conduit with calcified mural mass. She underwent surgical revision of the RVPA conduit with thromboendarterectomy of bilateral pulmonary arteries. Pathology of the removed conduit revealed fibrin-associated Epstein\u2013Barr virus-positive diffuse large B-cell lymphoma (FA DLBCL).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>One prior case report has demonstrated invasion of DLBCL involving an aortic synthetic tube graft. However, malignant invasion of the RVOT Gore-Tex conduit has yet to be reported. Pathological review can be essential in guiding management. Malignant invasion of Gore-Tex conduits is a rare phenomenon, but one that should be closely monitored following repair of the RVOT.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab402","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T15:44:42Z","timestamp":1633621482000},"source":"Crossref","is-referenced-by-count":1,"title":["A case report of right ventricular outflow tract obstruction caused by B-cell lymphoma: a rare presentation in an adult patient with pulmonary atresia"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7261-914X","authenticated-orcid":false,"given":"Payush","family":"Chatta","sequence":"first","affiliation":[{"name":"Division of Internal Medicine, Department of Medicine, Loma Linda University, 11234 Anderson St, Loma Linda, CA 92354, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Qureashi","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Department of Medicine, Loma Linda University, 11234 Anderson St, Loma Linda, CA 92354, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Plato","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Cardiology, Loma Linda University, 11234 Anderson St, Loma Linda, CA 92354, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon","family":"Kirk","sequence":"additional","affiliation":[{"name":"Division of Radiology, Loma Linda University Medical Center, 11234 Anderson St, Loma Linda, CA 92354, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Yau","sequence":"additional","affiliation":[{"name":"Division of Pathology, Loma Linda University Medical Center, 11234 Anderson St, Loma Linda, CA 92354, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Kheiwa","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of International Heart Institute, Loma Linda University, 11234 Anderson St, Loma Linda, CA 92354, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Purvi","family":"Parwani","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Loma Linda University, 11234 Anderson St, Loma Linda, CA 92354, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anees","family":"Razzouk","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Cardiology, Loma Linda University, 11234 Anderson St, Loma Linda, CA 92354, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"key":"2021103110200648400_ytab402-B1","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1097\/01.mat.0000176119.56534.90","article-title":"Mechanical valve replacement in congenital heart defects in the era of international normalized ratio self-management","volume":"51","author":"Reiss","year":"2005","journal-title":"ASAIO J"},{"key":"2021103110200648400_ytab402-B2","doi-asserted-by":"crossref","first-page":"806.e1","DOI":"10.1016\/j.ahj.2007.01.035","article-title":"Polytetrafluoroethylene graft calcification in patients with surgically repaired congenital heart disease: evaluation using multidetector-row computed tomography","volume":"153","author":"Hayabuchi","year":"2007","journal-title":"Am Heart J"},{"key":"2021103110200648400_ytab402-B3","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1097\/PAS.0b013e3181ce9128","article-title":"Epstein-Barr virus-associated diffuse large B-cell lymphoma arising on cardiac prostheses","volume":"34","author":"Miller","year":"2010","journal-title":"Am J Surg Pathol"},{"key":"2021103110200648400_ytab402-B4","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1097\/PAS.0000000000000775","article-title":"Fibrin-associated EBV-positive large B-cell lymphoma: an indolent neoplasm with features distinct from diffuse large B-cell lymphoma associated with chronic inflammation","volume":"41","author":"Boyer","year":"2017","journal-title":"Am J Surg Pathol"}],"container-title":["European Heart Journal - 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