ArticleAnnals of pediatric cardiology
Late thrombosis after an Amplatzer septal occluder in a child with multisystem inflammatory syndrome during the coronavirus disease 2019 pandemic.
Article in Annals of pediatric cardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Multisystem inflammatory syndrome in children (MIS-C), a postinfectious complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is characterized by hyperinflammation and a prothrombotic state. Thrombosis involving intracardiac devices is rare but potentially life-threatening. We report a 16-year-old girl who had transcatheter closure of a fossa ovalis atrial septal defect using an Amplatzer septal occluder at 4 years of age. During the ongoing coronavirus disease 2019 pandemic, she presented with fever, rash, elevated inflammatory markers, and positive SARS-CoV-2 antibody testing. Transthoracic echocardiography revealed a large mobile thrombus attached to the interatrial septum near the device. She was diagnosed with MIS-C and managed with intravenous immunoglobulin, corticosteroids, and unfractionated heparin. Serial echocardiography showed resolution of the thrombus within 5 days, and she was discharged on low-dose aspirin. This case highlights late thrombus formation on an atrial septal occluder in the context of MIS-C, emphasizing the need for echocardiographic surveillance and anticoagulation in children with prior cardiac interventions who present with hyperinflammatory syndromes.
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