HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Peter C. Laussen Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Odegard, K. C. Articles by Laussen, P. C. Search for Related Content PubMed PubMed Citation Articles by Odegard, K. C. Articles by Laussen, P. C. Related Collections Congenital - acyanotic Related Article

Ann Thorac Surg 2007;83:1797-1803
© 2007 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Evaluation of the Coagulation System in Children with Two-Ventricle Congenital Heart Disease

^a Departments of Anesthesiology, Perioperative and Pain Medicine, Children’s Hospital Boston, Harvard Medical School, Boston, Massachusetts
^b Division of Hematology, Children’s Hospital Boston, Harvard Medical School, Boston, Massachusetts

Accepted for publication December 18, 2006.

^_* Address correspondence to Dr Odegard, Cardiac Anesthesia Service, 300 Longwood Ave, Children’s Hospital Boston, Boston, MA 02115 (Email: kirsten.odegard{at}childrens.harvard.edu).

Background: Multiple coagulation factor abnormalities involving both procoagulant and anticoagulant proteins have been described in children with single-ventricle physiology. This study used age-matched controls to evaluate coagulation factors in children with two-ventricle congenital heart disease (CHD).

Methods: Coagulation factors were assayed in 120 patients with CHD, divided into four age groups: group 1, 0 to 3 months; group 2, 3 to 12 months; group 3, 12 to 48 months; and group 4, older than 48 months. Healthy children without CHD were assayed as controls. Concentration of factors II, V, VII, VIII, IX, and X; protein C and S, plasminogen, and antithrombin III, were measured by standard assays. Normal ranges were determined by the empirical 95% confidence intervals.

Results: Significant reductions were found in mean levels of both procoagulant and anticoagulant factors in patients in groups 1, 2, and 3 compared with controls, but no differences were found in group 4. In group 1, all variables had significantly lower concentrations except fibrinogen and protein S; in group 2, all variables had significantly lower concentrations except for fibrinogen, factors VIII and IX, and plasminogen and protein S; and in group 3, all variables had significantly lower concentrations except fibrinogen, factors VIII and IX, and antithrombin III, plasminogen, and protein S.

Conclusions: Neonates and infants with two-ventricle CHD have lower levels of procoagulant and anticoagulant factors compared with aged-matched controls approaching normal levels in children aged older than 4 years. These coagulation factor abnormalities are similar to those described in patients with single-ventricle physiology.

Related Article

Invited commentary

Joanne Guay
Ann. Thorac. Surg. 2007 83: 1803-1804. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				K. C. Odegard, D. Zurakowski, J. A. DiNardo, R. A. Castro, F. X. McGowan Jr., E. J. Neufeld, and P. C. Laussen Prospective longitudinal study of coagulation profiles in children with hypoplastic left heart syndrome from stage I through Fontan completion J. Thorac. Cardiovasc. Surg., April 1, 2009; 137(4): 934 - 941. [Abstract] [Full Text] [PDF]

				J. Guay Invited commentary Ann. Thorac. Surg., May 1, 2007; 83(5): 1803 - 1804. [Full Text] [PDF]