Reference : Children undergoing cardiac surgery for complex cardiac defects show imbalance between p...
Scientific journals : Article
Human health sciences : Pediatrics
http://hdl.handle.net/2268/92336
Children undergoing cardiac surgery for complex cardiac defects show imbalance between pro- and anti-thrombotic activity.
English
Heying, Ruth [Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiology > > >]
van Oeveren, Wim [University of Groningen > BioMedical Engineering > > >]
Wilhelm, Stefanie [Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiology > > >]
SCHUMACHER, Katharina [Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiology > > >]
Grabitz, Ralph G [Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiology > > >]
Messmer, Bruno J [Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Cardiothoracic and Vascular Surgery > > >]
SEGHAYE, Marie-Christine mailto [Rheinisch - Westfälische Technische Hochschule Aachen - RWTH > Pediatric Cardiology > > >]
2006
Critical Care
BioMed Central
10
6
R165
Yes (verified by ORBi)
International
1364-8535
1466-609X
London
United Kingdom
[en] Antithrombin III/analysis ; Blood Coagulation ; Blood Coagulation Tests ; Cardiac Surgical Procedures/adverse effects ; Child ; Child, Preschool ; Heart Bypass, Right/adverse effects ; Heart Defects, Congenital/surgery ; Humans ; Prospective Studies ; Thrombosis/etiology/physiopathology
[en] INTRODUCTION: Cardiac surgery with cardiopulmonary bypass (CPB) is associated with the activation of inflammatory mediators that possess prothrombotic activity and could cause postoperative haemostatic disorders. This study was conducted to investigate the effect of cardiac surgery on prothrombotic activity in children undergoing cardiac surgery for complex cardiac defects. METHODS: Eighteen children (ages 3 to 163 months) undergoing univentricular palliation with total cavopulmonary connection (TCPC) (n = 10) or a biventricular repair (n = 8) for complex cardiac defects were studied. Prothrombotic activity was evaluated by measuring plasma levels of prothrombin fragment 1+2 (F1+2), thromboxane B2 (TxB2), and monocyte chemoattractant protein-1 (MCP-1). Anti-thrombotic activity was evaluated by measuring levels of tissue factor pathway inhibitor (TFPI) before, during, and after cardiac surgery. RESULTS: In all patients, cardiac surgery was associated with a significant but transient increase of F1+2, TxB2, TFPI, and MCP-1. Maximal values of F1+2, TxB2, and MCP-1 were found at the end of CPB. In contrast, maximal levels of TFPI were observed at the beginning of CPB. Concentrations of F1+2 at the end of CPB correlated negatively with the minimal oesophageal temperature during CPB. Markers of prothrombotic activity returned to preoperative values from the first postoperative day on. Early postoperative TFPI levels were significantly lower and TxB2 levels significantly higher in patients with TCPC than in those with biventricular repair. Thromboembolic events were not observed. CONCLUSION: Our data suggest that children with complex cardiac defects undergoing cardiac surgery show profound but transient imbalance between pro- and anti-thrombotic activity, which could lead to thromboembolic complications. These alterations are more important after TCPC than after biventricular repair but seem to be determined mainly by low antithrombin III.
http://hdl.handle.net/2268/92336
10.1186/cc5108

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