Coagulation and Anticoagulation in Fontan Patients.

Autor: Heidendael JF; Department of Cardiology, Amsterdam University Medical Center, Amsterdam, The Netherlands. Electronic address: j.heidendael@amsterdamumc.nl., Engele LJ; Department of Cardiology, Amsterdam University Medical Center, Amsterdam, The Netherlands., Bouma BJ; Department of Cardiology, Amsterdam University Medical Center, Amsterdam, The Netherlands., Dipchand AI; Department of Pediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada., Thorne SA; Department of Cardiology, Peter Munk Cardiac Center, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada., McCrindle BW; Department of Pediatrics, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada., Mulder BJM; Department of Cardiology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: The Canadian journal of cardiology [Can J Cardiol] 2022 Jul; Vol. 38 (7), pp. 1024-1035. Date of Electronic Publication: 2022 Feb 03.
DOI: 10.1016/j.cjca.2022.01.028
Abstrakt: Patients with a Fontan circulation for single-ventricle physiology are at increased risk of developing thromboembolic events. Thromboembolic events can lead to failure of the Fontan circulation, chronic sequelae in case of stroke, and early mortality. Controversies exist regarding the substrates, risk factors, and optimal detection methods for thromboembolic events. Despite the major clinical implications, there is currently no consensus regarding the optimal antithrombotic therapy to prevent or treat thromboembolic events after the Fontan procedure. In this review we aimed to untangle the available literature regarding antithrombotic prophylaxis and treatment for pediatric and adult Fontan patients. A decision-tree algorithm for thromboprophylaxis in Fontan patients is proposed. Additionally, the current state of knowledge is reviewed with respect to the epidemiology, pathophysiology, and detection of thromboembolic events in Fontan patients, and important evidence gaps are highlighted.
(Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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