The pulmonary artery closure may be a thromboembolic risk factor in patients with bidirectional cavo-pulmonary shunt (Glenn)

Postoperative thrombosis after the Fontan procedure has been well noted in the literature, and its risk factors are also well known. In contrast, thro mbosis after the bilateral cavopulmonary shunt (Glenn) has been rarely repo rted and almost always occurs around the anastomosis itself or near it, mai nly causing pulmonary embolism. We present 2 cases with cerebral embolism 2 -7 months after pulmonary artery closure and Glenn procedure, due to dislod gement of a thrombus in the proximal pulmonary artery stump. Based on these two cases and a few others reported in the literature, we want to call the attention to this new cause of thromboembolism after Glenn and stimulate d iscussion about its incidence, risk factors and preventive measures.