Saddle arterial embolus in a patient with Down syndrome

We report acute thromboembolic events in a 14-year-old boy with Down syndrome and repaired atrioventricular septal defect. He presented with sudden onset of bilateral lower limb ischemia. Transesophageal echocardiography detected a thrombus in the right atrium. An arterial saddle embolus was removed...

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Bibliographic Details
Published in:Pediatric cardiology 2006-02, Vol.27 (1), p.117-121
Main Authors: Mohan, U R, Mangat, J S, Sutaria, N, Franklin, R C G
Format: Article
Language:English
Subjects:
Adolescent
Aorta, Abdominal - surgery
Aortography
Case studies
Congenital heart disease
Down syndrome
Down Syndrome - complications
Echocardiography, Transesophageal
Embolectomy
Embolism
Heart Atria - surgery
Heart Septal Defects, Atrial - surgery
Heart Septal Defects, Ventricular - surgery
Humans
Iliac Artery - surgery
Image Processing, Computer-Assisted
Ischemia - diagnosis
Ischemia - surgery
Leg - blood supply
Male
Postoperative Complications - diagnosis
Postoperative Complications - surgery
Risk Factors
Thromboembolism - diagnosis
Thromboembolism - surgery
Tomography, X-Ray Computed
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Summary:We report acute thromboembolic events in a 14-year-old boy with Down syndrome and repaired atrioventricular septal defect. He presented with sudden onset of bilateral lower limb ischemia. Transesophageal echocardiography detected a thrombus in the right atrium. An arterial saddle embolus was removed following bilateral iliac embolectomy. Despite anticoagulation, he presented again with sudden bilateral lower limb ischemia and respiratory distress. Multiple pulmonary emboli and a thrombus in the right atrium were noted on imaging studies. An arterial embolus was removed from the abdominal aorta at the bifurcation. To our knowledge, this is the first report of a child or adolescent with a repaired congenital heart lesion and arterial embolism requiring embolectomy. This association and possible etiological factors are discussed.
ISSN:0172-0643
1432-1971
DOI:10.1007/s00246-005-0871-1