Hypercoagulability markers predict thrombosis in single ventricle neonates undergoing cardiac surgery

Area of Science:

• Cardiovascular Surgery
• Neonatal Medicine
• Hematology

Background:

• Thrombosis incidence in neonates undergoing cardiac surgery is significant, potentially higher in single ventricle physiology (SVP).
• SVP and cardiopulmonary bypass (CPB) are investigated as risk factors for neonatal thrombosis.
• Hypercoagulability biomarkers are explored for their predictive value in postoperative thrombosis.

Purpose of the Study:

• To determine if single ventricle physiology (SVP) is an independent risk factor for thrombosis in neonates undergoing cardiac surgery.
• To assess the predictive value of hypercoagulability biomarkers for postoperative thrombosis in neonates with SVP.
• To analyze the association between clinical variables and thrombosis development.

Main Methods:

• Retrospective review of 512 neonates undergoing cardiac surgery.
• Thrombosis defined by clinical events or echocardiographic findings.
• Multivariable logistic regression used to analyze risk factors including SVP and CPB; biomarker analysis in a subset of SVP patients.

Main Results:

• Thrombosis occurred in 51 of 512 neonates; SVP and CPB were significant risk factors.
• Thrombosis rate was 16.2% in SVP patients versus 8.5% in non-SVP patients (p=0.038).
• Elevated thrombin generation, plasminogen activator inhibitor, and thrombin activatable fibrinolysis inhibitor were observed in SVP patients with thrombosis.

Conclusions:

• Single ventricle physiology (SVP) increases thrombosis risk in neonates post-cardiac surgery.
• Hypercoagulable panel testing shows potential for risk stratification.
• Biomarker testing may guide individualized anticoagulation strategies in the postoperative period.