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Related Experiment Videos

Coagulation factor abnormalities after the Fontan procedure and its modifications

M Jahangiri1, D Shore, V Kakkar

  • 1Department of Paediatric Cardiology and Cardiac Surgery, Royal Brompton Hospital, London, United Kingdom.

The Journal of Thoracic and Cardiovascular Surgery
|June 1, 1997
PubMed
Summary

Patients undergoing the Fontan procedure may have lower levels of protein C, protein S, and factor VII, increasing thromboembolism risk. Anticoagulant therapy may be beneficial for these individuals.

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Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Hematology

Background:

  • Thromboembolism is a known complication after the Fontan procedure.
  • Hemodynamic factors are implicated, but coagulation abnormalities may also contribute.
  • Investigating coagulation status is crucial for understanding post-Fontan risks.

Purpose of the Study:

  • To investigate the coagulation status in children who have undergone the Fontan procedure.
  • To identify potential coagulation factor abnormalities contributing to thromboembolism.
  • To assess the clinical implications of these findings for patient management.

Main Methods:

  • Studied 20 children post-Fontan procedure or modifications.
  • Assessed coagulation factor abnormalities.

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  • Measured serum albumin, total protein, and liver enzymes.

    • Main Results:

    • Significantly lower levels of protein C (p < 0.001), protein S (p < 0.02), and factor VII (p < 0.001) were observed.
    • No significant changes in serum albumin, total protein, or factors II, IX, and X.
    • These deficiencies were noted in patients with a median age of 6.2 years, a median of 4.9 years post-repair.

    Conclusions:

    • Deficiencies in protein C, protein S, and factor VII may contribute to thromboembolism after Fontan repairs.
    • Reduced levels of these factors should be considered risk factors.
    • Anticoagulant therapy should be considered for patients with these deficiencies, balancing risks and benefits.