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Embolic stroke in a postpartum patient with Fontan physiology
  1. Katherine VanHise1,
  2. Linda Li2,
  3. Emily Smith3,
  4. Niamh Condon3
  1. 1Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania, USA
  2. 2Department of Obstetrics and Gynecology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
  3. 3Department of Maternal Fetal Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
  1. Correspondence to Katherine VanHise, kvanhise{at}


In cardiac physiology, single ventricle typically refers to the presence of a dominant systemic ventricle along with a hypoplastic ventricle. The Fontan operation is used to repair the single ventricle by directing deoxygenated systemic venous flow to the pulmonary arterial circulation. Normal pregnancy physiology, particularly increased intravascular volume, increased heart rate, increased cardiac output, hypercoagulability and decreased systemic vascular resistance, can exacerbate cardiac disease in patients with Fontan circulation, leading to pregnancy complications. Despite the known risks, there are limited data addressing the question of anticoagulation in pregnant patients with Fontan physiology. Herein we present the case of a Fontan patient who had a successful pregnancy and delivery, and developed an embolic stroke in the postpartum period.

  • pregnancy
  • obstetrics and gynaecology
  • stroke
  • cardiovascular medicine

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  • Contributors Retrieval and selection of appropriate resources: KV, LL, ES. Drafting of manuscript: KV, LL, ES, NC. Revision of manuscript: KV, LL, ES, NC. All authors had authority over the decision to submit the manuscript for publication to BMJ Case Reports.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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