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Case Report
©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Oct 26, 2023; 15(10): 542-552
Published online Oct 26, 2023. doi: 10.4330/wjc.v15.i10.542
Systemic right ventricle complications in levo-transposition of the great arteries: A case report and review of literature
Karthikeyan Ananthasubramaniam, Mark S Obri, Naoshin Khan, Abdulla Almajed, Mohamed Ramzi Almajed
Mohamed Ramzi Almajed, Naoshin Khan, Mark S Obri, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, United States
Abdulla Almajed, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 00000, Bahrain
Karthikeyan Ananthasubramaniam, Heart and Vascular Institute, Henry Ford West Bloomfield Hospital, West Bloomfield, MI 48322, United States
Author contributions: Almajed MR, Almajed A, Khan N, Obri M, Ananthasubramaniam K contributed equally to this work; All authors evaluated the case, reviewed the literature, and wrote the manuscript; All authors have read and approve of the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: Dr. Ananthasubramaniam has nothing to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Karthikeyan Ananthasubramaniam, FACC, MD, Staff Physician, Heart and Vascular Institute, Henry Ford West Bloomfield Hospital, 6777 W Maple, West Bloomfield, MI 48322, United States. kananth1@hfhs.org
Received: June 17, 2023
Peer-review started: June 17, 2023
First decision: August 10, 2023
Revised: August 23, 2023
Accepted: September 27, 2023
Article in press: September 27, 2023
Published online: October 26, 2023
Processing time: 129 Days and 1.8 Hours
Core Tip

Core Tip: Patients with congenital heart disease such as levo-transposition of the great arteries experience progressive cardiac dysfunction and remodeling which manifests as heart failure. This predisposes patients to the formation of intracardiac thrombus (ICT). We present a case of progressive systemic right ventricle (sRV) dysfunction resulting in an apical thrombus. Review of literature identified no cases of sRV thrombus making this one of the first reports. Guidelines do not exist for anticoagulation in patients with congenital heart disease and ICT. Therefore, clinical decisions are extrapolated from anticoagulation principles in patients without congenital heart disease. Considerations for direct oral anticoagulants in this population should be individualized and involve shared decision making.