Mair D D, Fulton R E, Danielson G K
Mayo Clin Proc. 1978 Jun;53(6):397-402.
Six months after undergoing a Fontan procedure for tricuspid valve atresia, a 7-year-old child experienced thrombotic occlusion of the Hancock conduit coincident with an acute gastroenterologic illness that produced sudden, severe dehydration. Recovery from this complication was possible only by virtue of pulmonary blood flow through a Glenn anastomosis, which had been constructed at 1 year of age and which was left in place at the time of the Fontan procedure. At subsequent reoperation, the Hancock conduit, which was completely occluded with organized thrombus, was replaced with another Hancock conduit, and the patient is now doing well 10 months after this last operation. The relatively nonpulsatile flow characteristic of blood passing through the prosthetic conduit after the Fontan operation predisposes the patient to the possibility of the potentially lethal complication, previously unreported, of thrombotic occlusion of the conduit, and care must be taken to avoid severe dehydration in such patients.
一名7岁儿童因三尖瓣闭锁接受Fontan手术6个月后，汉考克导管出现血栓性闭塞，同时发生急性胃肠疾病，导致突然、严重脱水。仅借助于通过1岁时构建且在Fontan手术时保留的格林吻合术实现的肺血流，才有可能从这一并发症中恢复。在随后的再次手术中，完全被机化血栓阻塞的汉考克导管被另一个汉考克导管替换，该患者在最后一次手术后10个月目前情况良好。Fontan手术后通过人工导管的血流相对无搏动的特性使患者易发生导管血栓性闭塞这一潜在致命并发症的可能性，此前未见报道，对此类患者必须注意避免严重脱水。
