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Successful conservative treatment of pulmonary thromboembolism in unrepaired d-transposition of the great arteries with pulmonary hypertension: a case report

  • Putu Andrie Setiawan ,
  • Ni Putu Veny Kartika Yantie ,
  • Eka Gunawijaya ,
  • Ni Putu Siadi Purniti ,
  • Ida Bagus Subanada ,
  • Ayu Setyorini Mestika Mayangsari ,

Abstract

Background: Unrepaired dextro-transposition of great arteries (D-TGA) is well known for long-term complications, including tricuspid valve regurgitation, arrhythmias, and coronary artery abnormalities. Pulmonary hypertension (PH) is a frequent, progressive, and fatal complication in unrepaired CHD. This chronic condition can induce pulmonary thromboembolism (PTE). Aim: To report the management of PTE in unrepaired D-TGA with PH.

Case Presentation: We present a rare case of an eleven-year-old male in unrepaired D-TGA with PH. He came with hemoptysis with no sign of acute or chronic infection. This condition was not associated with endocarditis or tuberculosis. The patient underwent a CT-pulmonary angiography examination and found a filling defect in the apical and posterior branches of the right superior pulmonary artery, suggesting a PTE that caused pulmonary parenchymal infarction. He was treated with intravenous low molecular weight heparin (LMWH) for ten days (1 mg/kg) and tranexamic acid. On follow-up, he did not experience cardiovascular collapse or hypotension; by the day, the hemoptysis had decreased in frequency and volume. He received long-term warfarin (2 mg/day) for three months. After three months of follow-up, the PTE was not visualized from CT-pulmonary angiography.

Summary: Hemoptysis is rare and life-threatening in unrepaired CHD. Heparin administration continued with warfarin, and tranexamic acid provides a good prognosis in patients with PTE with D-TGA and PH.

Section

References

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How to Cite

Setiawan, P. A., Yantie, N. P. V. K. ., Gunawijaya, E. ., Purniti, N. P. S. ., Subanada, I. B. ., & Mayangsari, A. S. M. . (2023). Successful conservative treatment of pulmonary thromboembolism in unrepaired d-transposition of the great arteries with pulmonary hypertension: a case report . Indonesia Journal of Biomedical Science, 17(2), 317–319. https://doi.org/10.15562/ijbs.v17i2.498

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Putu Andrie Setiawan
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Ni Putu Veny Kartika Yantie
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Eka Gunawijaya
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Ni Putu Siadi Purniti
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Ida Bagus Subanada
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Ayu Setyorini Mestika Mayangsari
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