Systemic oxygen saturation and coagulation factor abnormalities before and after the fontan procedure

Area of Science:

• Cardiology
• Hematology
• Pediatric Congenital Heart Disease

Background:

• Thromboembolism risk after Fontan procedure is linked to coagulation abnormalities.
• Emerging evidence suggests these abnormalities may exist prior to the Fontan procedure.

Purpose of the Study:

• To investigate coagulation factor abnormalities in patients with single-ventricle congenital heart defects before the Fontan procedure.
• To compare pre-Fontan coagulation status with post-Fontan patients and age-matched controls.

Main Methods:

• Assessed liver function, coagulation factor levels, and pulse oximetry in 11 pre-Fontan patients.
• Compared findings with 11 post-Fontan patients and 11 age-matched controls.
• Utilized analysis of variance and Tukey's post hoc test for statistical analysis.

Main Results:

• Pre-Fontan patients exhibited significantly lower levels of protein C, protein S, antithrombin III, and factors II, V, VII, X compared to controls.
• Pre-Fontan patients showed longer prothrombin times than controls.
• Pre-Fontan patients had lower levels of protein S, protein C, and antithrombin III compared to post-Fontan patients.
• Systemic oxygen saturation positively correlated with anticoagulant and procoagulant levels.

Conclusions:

• Coagulation factor abnormalities precede the Fontan procedure in single-ventricle patients.
• These abnormalities appear to normalize post-Fontan procedure, potentially linked to improved systemic oxygenation.