Elevated risk of thrombosis in neonates undergoing initial palliative cardiac surgery.

Elevated risk of thrombosis in neonates undergoing initial palliative cardiac surgery. Research Abstract Details 

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Elevated risk of thrombosis in neonates undergoing initial palliative cardiac surgery. Abstract Text:

Jill M Cholette,Jeffrey S Rubenstein,George M Alfieris,Michael P McDermott,William G Harmon,Roger Vermilion,Michael P Eaton,James J Gangemi,Norma B Lerner,Jill M Cholette,Jeffrey S Rubenstein,George M Alfieris,Michael P McDermott,William G Harmon,Roger Vermilion,Michael P Eaton,James J Gangemi,Norma B Lerner,

BACKGROUND: Thrombotic events cause significant morbidity and mortality in children who undergo surgery for complex congenital cardiac disease. We prospectively evaluated the incidence of thrombosis and examined preoperative and postoperative laboratory tests of coagulation and inflammation in neonates experiencing initial surgical palliation for variations of single ventricle physiology. METHODS: Neonates (<30 days) requiring initial surgical palliation were studied. All subjects received aspirin from postoperative day 1 onward. Thromboses were diagnosed by serial transthoracic echocardiograms, vascular imaging, and interstage cardiac catheterizations according to predefined criteria. RESULTS: Twenty-two neonates, age 1 to 11 days (mean 4 +/- 2.5) were studied. Follow-up ranged from three hours to 18 months (median, 212 days). Eight infants died. Four of the 14 subjects who survived (28%), and one of the eight who died (12.5%), had evidence of thrombosis identified over a range of four hours to nine months postoperatively (median 14 days). When compared with reference values established in healthy children, preoperative subject hematocrit (Hct), platelet count, factors II, V, VII, VIII, and X, antithrombin, protein C, and soluble CD40 ligand measures were significantly lower, and the prothrombin time and partial thromboplastin time were significantly higher. Postoperative C reactive protein (CRP) was significantly higher, and Hct and platelet count significantly lower, than preoperative values. Thrombotic events were significantly related to high preoperative CRP (p = 0.02). CONCLUSION: Thrombotic complications occur frequently in neonates undergoing initial palliative surgery, suggesting that aspirin therapy alone may constitute inadequate protection. Elevated preoperative CRP appears to be associated with increased thrombotic risk.

Elevated risk of thrombosis in neonates undergoing initial palliative cardiac surgery. Publishing Authors By Initials

JM Cholette,JS Rubenstein,GM Alfieris,MP McDermott,WG Harmon,R Vermilion,MP Eaton,JJ Gangemi,NB Lerner,JM Cholette,JS Rubenstein,GM Alfieris,MP McDermott,WG Harmon,R Vermilion,MP Eaton,JJ Gangemi,NB Lerner,

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Elevated risk of thrombosis in neonates undergoing initial palliative cardiac surgery. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: The Annals of thoracic surgery

VOLUME: 84

Page Numbers: 1320-5

Journal Abbreviation: Ann. Thorac. Surg.

ISSN: 1552-6259

DAY: 24

MONTH: Oct

YEAR: 2007

Elevated risk of thrombosis in neonates undergoing initial palliative cardiac surgery. Information

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LANGUAGE: eng

NlmUniqueID: 15030100

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Grant and Affiliation Information for Elevated risk of thrombosis in neonates undergoing initial palliative cardiac surgery.

AFFILIATION: Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, USA.

Country: Netherlands

AGENCY: United States NINDS

GRANT: K24 NS048323

ACRONYM: NS

MEDLINETA: Ann Thorac Surg

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