Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Feb;3(2):187-191.
doi: 10.1016/j.jaccas.2020.10.032. Epub 2021 Feb 3.

A 40-Year-Old Man With Tricuspid Atresia, Status Post-Fontan, With Severe COVID-19 Pneumonia and Pneumothorax

Sumeet S Vaikunth  1 , Michael R Bykhovsky  1 , Anitra W Romfh  1   2 , Christiane L Haeffele  1   2 , Ian S Rogers  1   2 , Emily Dong  1   2 , Caroline Scribner  1   2 , George K Lui  1   2
Affiliations
Case Reports

A 40-Year-Old Man With Tricuspid Atresia, Status Post-Fontan, With Severe COVID-19 Pneumonia and Pneumothorax

Sumeet S Vaikunth et al. JACC Case Rep. 2021 Feb.

Abstract

We report a case of COVID-19 in an adult single-ventricle patient post-Fontan-to our knowledge, the first report in this population documenting the use of the latest management recommendations for this novel disease. Additionally, this patient had significant pre-existing ventricular dysfunction, valvular disease, and comorbidities including HIV. (Level of Difficulty: Advanced.).

Keywords: ART, antiretroviral therapy; COVID-19, coronavirus disease-2019; HFNC, high-flow nasal cannula; PVR, pulmonary vascular resistance; SARS-CoV-2, severe acute respiratory syndrome-coronavirus-2; anticoagulation; congenital heart defect; pulmonary circulation.

PubMed Disclaimer

Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Diagram of Fontan Circulation in a Patient With Tricuspid Atresia LA = left atrium; LV = left ventricle; RA = right atrium; SVC-BDG = superior vena cava-bidirectional glenn.
Figure 2
Figure 2
Initial and Repeat Chest X-Ray Films (A) Chest x-ray film showing large left pneumothorax with (B) subsequent placement of pigtail chest tube.
Figure 3
Figure 3
Transthoracic Echocardiogram (A) Parasternal long-axis view with color Doppler and (B) suprasternal notch view showing moderate to severe aortic regurgitation (diastolic flow reversal in the descending aorta).
Figure 4
Figure 4
The 12-Lead Electrocardiogram Electrocardiogram showing a sinus versus ectopic atrial rhythm at a rate of 113 beats/min with a right bundle branch block, QRS duration of 113 ms, and QTc interval of 480 ms.
Figure 5
Figure 5
Computed Tomography of the Chest Computed tomography of the chest in the (A) axial plane and (B) coronal plane showing large loculated left-sided hemopneumothorax causing partial collapse of the left upper and lower lobes.
See this image and copyright information in PMC

References

    1. Ahluwalia N., Love B., Chan A., Zaidi A.N. COVID-19 in an Adult with tricuspid atresia S/P Fontan palliation. J Am Coll Cardiol Case Rep. 2020;2:1261–1266. - PMC - PubMed
    1. Beigel J.H., Tomashek K.M., Dodd L.E. Remdesivir for the treatment of Covid-19 - final report. N Engl J Med. 2020;383:1813–1826. - PMC - PubMed
    1. The RECOVERY Collaborative Group Dexamethasone in hospitalized patients with Covid-19—preliminary report. N Engl J Med. 2020 Jul 17 [E-pub ahead of print]
    1. Alviar C.L., Miller P.E., McAreavey D. Positive pressure ventilation in the cardiac intensive care unit. J Am Coll Cardiol. 2018;72:1532–1553. - PMC - PubMed
    1. Chugh R. The Fontan thromboprophylaxis dilemma. J Am Coll Cardiol. 2019;74:1082–1085. - PubMed

Publication types