PSEUDO-THROMBOSIS OF THE SUPERIOR VENA CAVA AS A MANIFESTATION OF PULMONARY HYPERTENSION CRISIS AFTER GLENN PROCEDURE

Abstract

Objective. Pulmonary hypertension is one of the typical complications of the congenital heart defects with pulmonary overload circulation. Hemodynamic status of the pulmonary circulation is critically important for the patients with univentricular heart anatomy and determines opportunities and results of the surgical treatment. Case report. We present a case report of superior vena cava syndrome feigning a thrombosis of the anastomosis in a patient after Glenn procedure. Clear clinical picture, hemodynamic instability of the patient and inability to exclude anastomosis dysfunction were an indication for re-operation. There were no signs of anastomosis dysfunction or thrombosis. This clinical situation was assessed as a manifestation of pulmonary hypertension (PH) feigning a thrombosis of the Glenn anastomosis. Applying of pulmonary vasodilation agents gave an opportunity to avoid a PH crisis and promoted stable postoperative period. Conclusions. In consideration of our clinical experience we believe that inclusion of computer tomography scan or magnetic resonance imaging into examination protocol is appropriate for the patients with high risk of PH crisis.