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Long-term anticoagulation therapy and thromboembolic complications after the Fontan procedure

Y F Cheung1, George W Chay, Clement S W Chiu

  • 1Department of Paediatrics and Adolescent Medicine, Division of Paediatric Cardiology, Grantham Hospital, The University of Hong Kong, Aberdeen, Hong Kong, People's Republic of China. xfcheung@hkucc.hku.hk

International Journal of Cardiology
|July 12, 2005
PubMed

Insights

Chronic anticoagulation may not be necessary for most ethnic Chinese Fontan patients. However, it may be considered for individuals with specific risk factors like dilated right atrium or arrhythmias.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiovascular Surgery

Background:

  • The necessity of long-term anticoagulation for Fontan patients is debated.
  • This study investigates thromboembolic complication rates in relation to anticoagulation strategies post-Fontan procedure.

Purpose of the Study:

  • To determine the prevalence of thromboembolic complications in ethnic Chinese Fontan patients.
  • To evaluate the effectiveness of different long-term anticoagulation strategies.

Main Methods:

  • Retrospective review of clinical outcomes, anticoagulation strategies, and thromboembolic events.
  • Analysis of 102 ethnic Chinese patients who underwent the Fontan procedure between 1980 and 2002.

Main Results:

  • Early and late mortality rates were 10.8% and 5.8%, respectively, unrelated to thromboembolism.
  • Thromboembolic complications occurred in 4.5% of survivors, irrespective of warfarin use.
  • Patients without chronic anticoagulation showed no increased risk of thromboembolism compared to those on warfarin.

Conclusions:

  • Chronic anticoagulation may not be required for the majority of ethnic Chinese Fontan patients.
  • Consideration for anticoagulation may be warranted in patients with a dilated right atrium, cardiac arrhythmias, or residual right-to-left shunts.
Abstract

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