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Ann Thorac Surg 1983;36:289-294
© 1983 The Society of Thoracic Surgeons

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Articles

Defective Platelet Aggregation in Patients Undergoing Surgical Repair of Cyanotic Congenital Heart Disease

From the Pulmonary Disease and Perfusion Technology sections, St. Luke's Episcopal Hospital and the Texas Heart Institute, Houston, TX

Accepted for publication August 2, 1982.

^* Address reprint requests to Dr. Solis, B-516 Pulmonary Research Laboratory, St. Luke's Episcopal Hospital, 6720 Bertner Ave, Houston, TX 77030

Fifteen patients undergoing cardiopulmonary bypass for repair of cyanotic congenital defects were examined for evidence of platelet aggregation abnormalities by means of electronic particle sizing. Eight patients with polycythemia whose hematocrits were greater than or equal to 50% before bypass were compared with 7 patients without polycythemia whose hematocrits were less than 50%. Patients also were compared with 11 healthy volunteers. Before bypass, platelets in blood from the patients with polycythemia formed markedly smaller platelet aggregates (8.9 ± 0.8 x 10³ µ³; mean ± standard error of the mean) in response to adenosine diphosphate than those of the other group of patients (21.7 ± 1.9 x 10³ µ³; p < 0.001) or healthy volunteers (25.8 ± 2.1 x 10³ µ³; p < 0.001). Mean platelet aggregate sizes were not different between patients without polycythemia and normal volunteers (p > 0.05). In samples taken after bypass, patients with polycythemia again had smaller aggregates than the other group of patients (p < 0.005). This platelet defect is quantitatively related to polycythemia, and may be a mechanical effect of the excess erythrocytes.

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