Post-pump chorea: Choreoathetosis after cardiac surgery with hypothermia and extracorporeal circulation

Abstract

Post-pump chorea is the development of choreo-athetoid movements within 2 wk following cardiopulmonary bypass, typically after an initial asymptomatic period. Choreoathetosis after congenital heart surgery has been described since 1960. It is seen in 1% to 3% of patients, from older infants to those in mid-childhood, and can be severe and irreversible, with a significant death rate. It is associated with orofacial dyskinesias, hypotonia, ballismus, supranuclear gaze palsy, affective changes and pseudobulbar signs. We describe a child who developed post-pump chorea after cardiac surgery, along with our management of this case. This is followed by a literature review of this rare but interesting condition.

Keywords

Chorea - cardiac surgery - children