Single Ventricle Physiology Patients and Coagulation Abnormalities: Is Therea Relationship With Hemodynamic Data and Postoperative Course? A PilotStudy

摘要

This study evaluates coagulation profiles of single ventricle (SV) patients inrelationship to liver function, hemodynamic variables and outcome. Twenty-six childrenwith SV anatomy were included. Advanced coagulation profiles, invasive preoperativehemodynamic parameters and clinical course were retrospectively analyzed. Median(interquartile range) age and weight at the time of blood sampling was 25.5 (31) monthsand 10.5 (6.9) kg. Sixteen patients (16/26; 62%) showed decreased antithrombin and/orprotein C (PC) and/or free protein S (PS) function and/or free PS antigen. Two patientsshowed abnormal activated PC resistance ratio due to heterozygous factor V Leiden mutationand 1 heterozygous prothrombin G20210A mutation. Group comparison (abnormal coagulationprofile [group 1; n = 16] versus normal coagulation profile [group 2; n = 10]) showedlonger postoperative hospitalization time ( = .04), longer postoperativecatecholamine support ( = .01), a higher incidence of thromboembolicevents ( = .04), and chylothoraxes ( = .007) in group1. In 5 (31%) of 16 group 1 patients, thromboembolic complications occurred: cerebralstroke (n = 1), intestinal ischemia (n = 2), thrombus formation in inferior caval vein (n= 1), and pulmonary vein (n = 1). Abnormalities in coagulation parameters are common in SVpatients. Coagulation abnormalities constitute a preoperative risk factor and affectpostoperative course.