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A Multifaceted Approach to the Management of Plastic Bronchitis After Cavopulmonary Palliation

Tuesday, August 5, 2014

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Source

Source Name: Annals of Thoracic Surgery

Author(s)

Catherine M. Avitabile, David J. Goldberg, Kathryn Dodds, Yoav Dori, Chitra Ravishankar, Jack Rychik

The formation of endotracheal casts comprised of inflammatory debris (plastic bronchitis) is a rare but life-threatening complication of the Fontan procedure.  This summary of 14 pts so affected demonstrated a mean interval to development of plastic bronchitis of 1.5 years.  Casts were treated with outpt t-PA (13 pts) and pulmonary vasodilators.  Lesions of the Fontan pathway were hemodynamically significant in 12 pts, and 3 pts required heart transplantation.  2 transplant pts and 6 t-PA pts were asymptomatic at last follow-up.   

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