{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T21:55:10Z","timestamp":1790978110427,"version":"4.1.0"},"reference-count":10,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thrombosis of the Fontan circuit or inferior vena cava (IVC) is an uncommon but serious early postoperative complication that can result in conduit obstruction and hemodynamic compromise. Early detection and timely intervention are critical to prevent Fontan pathway failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively reviewed 5 consecutive patients who developed imaging-confirmed venous thrombosis within the first postoperative week following Fontan completion surgery. The cohort included 1 detailed index case and 4 additional cases managed at the same institution. All patients presented with persistent, culture-negative fever between postoperative days 3 and 5. Thrombus location, treatment strategy, and outcomes were analyzed. Systemic thrombolysis was performed using recombinant tissue plasminogen activator (tPA; alteplase; 0.1\u2005mg\u2005kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      bolus followed by 0.5\u2005mg\u2005kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u2005h\n                      <jats:sup>\u22121<\/jats:sup>\n                      for 6\u2005h, maximum 50\u2005mg) under continuous unfractionated heparin infusion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thrombus sites included the IVC (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20093), iliac veins (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091), and extracardiac conduit (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091). Three patients\u2014including the index case\u2014received systemic tPA with complete radiological resolution and no bleeding or neurological complications. Two patients were successfully managed with 48\u2005h of heparin infusion alone. Fever subsided within 48\u2005h of therapy, and all patients achieved complete venous recanalization within 2 to 3 days. No patient experienced rethrombosis or major bleeding during 3 to 6 months of follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Persistent postoperative fever in a Fontan patient should prompt evaluation for thrombus formation, particularly when infection is excluded. Both short-course systemic thrombolysis and therapeutic heparinization are safe and effective first-line strategies for early post-Fontan thrombosis when applied under strict multimodal monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501351261428080","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T14:33:06Z","timestamp":1775658786000},"page":"785-790","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Systemic Thrombolysis and Anticoagulation for Early Post-Fontan Thrombosis: A Five-Patient Case Series"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4714-8868","authenticated-orcid":false,"given":"Sanketh","family":"Edem","sequence":"first","affiliation":[{"name":"Post Graduate Institute of Medical Education and Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lasya","family":"Reddy","sequence":"additional","affiliation":[{"name":"Post Graduate Institute of Medical Education and Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand Kumar","family":"Mishra","sequence":"additional","affiliation":[{"name":"Post Graduate Institute of Medical Education and Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parag","family":"Barwad","sequence":"additional","affiliation":[{"name":"Post Graduate Institute of Medical Education and Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3907-3138","authenticated-orcid":false,"given":"Naveen Deep","family":"Kaur","sequence":"additional","affiliation":[{"name":"Post Graduate Institute of Medical Education and Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghuveer","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Post Graduate Institute of Medical Education and Research"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2004.051789"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000696"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2016.09.014"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/0256-4947.62840"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)02472-9"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2022.04.028"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjtc.2024.07.017"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytad238"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951125101315"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1053\/pcsu.2002.29716"}],"container-title":["World Journal for Pediatric and Congenital Heart Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351261428080","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501351261428080","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351261428080","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T21:26:40Z","timestamp":1790976400000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501351261428080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,8]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/21501351261428080"],"URL":"https:\/\/doi.org\/10.1177\/21501351261428080","relation":{},"ISSN":["2150-1351","2150-136X"],"issn-type":[{"value":"2150-1351","type":"print"},{"value":"2150-136X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,8]]}}}