• Ann. Thorac. Surg. · Aug 2013

    Hypercoagulability markers predict thrombosis in single ventricle neonates undergoing cardiac surgery.

    • Sirisha Emani, David Zurakowski, Christopher W Baird, Frank A Pigula, Cameron Trenor, and Sitaram M Emani.
    • Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA. sitaram.emani@cardio.chboston.org
    • Ann. Thorac. Surg. 2013 Aug 1;96(2):651-6.

    BackgroundIncidence of thrombosis in neonates undergoing cardiac surgery is as high as 20%, and single ventricle physiology (SVP) may present an even higher risk. We hypothesize that SVP is a risk factor for thrombosis in neonates undergoing cardiac surgery, and hypercoagulability biomarkers are predictive of postoperative thrombosis.MethodsRecords of 512 neonates undergoing cardiac surgery were retrospectively reviewed. Thrombosis was defined by clinical events (shunt thrombosis, limb ischemia, and stroke) or intravascular or cardiac thrombus by echocardiography. Clinical variables, including SVP and cardiopulmonary bypass (CPB), were analyzed using multivariable logistic regression. A hypercoagulability biomarker panel was obtained in a subset of patients with SVP and compared between neonates with and without thrombosis.ResultsThrombosis was detected in 51 of 512 neonates undergoing cardiac surgery. Intensive care and hospital lengths of stay were longer in patients who experienced thrombosis compared with those who did not (14 ± 13 vs 6 ± 1 days, 23 ± 4 vs 13 ± 1 days, p < 0.001). The SVP and use of CPB were significant risk factors for thrombosis, and the rate of thrombosis in SVP patients was 16.2% (16 of 99) compared with 8.5% (35 of 413) in non-SVP patients (p = 0.038). Thrombin generation, plasminogen activator inhibitor, and thrombin activatable fibrinolysis inhibitor were significantly elevated in SVP patients with thrombosis compared to without thrombosis (p < 0.05).ConclusionsSingle ventricle physiology patients are at higher risk for thrombosis compared with other neonates after cardiac surgery. Hypercoagulable panel testing may help risk stratify patients and guide patient specific anticoagulation management in the postoperative period.Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…