Congenital cardiac lesions involving systolic flow abnormalities are associated with platelet dysfunction in children
| Autor: | Julie Martchenke, Laurie B. Armsby, Paul Sochacki, Vanessa Rogers, A. Roger Hohimer, Lynn K. Boshkov, Muhammad Zubair, Gurion Lantz, David K. Bailly, Stephen M. Langley |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Pulmonary and Respiratory Medicine
Heart Defects Congenital Male medicine.medical_specialty Adolescent Systole Diastole Pulmonary insufficiency Hematocrit Lesion Bidirectional Glenn procedure Internal medicine medicine Humans Child Tetralogy of Fallot medicine.diagnostic_test business.industry PFA-100 Age Factors Infant Newborn Infant medicine.disease Stenosis Anesthesia Child Preschool Cardiology Surgery Female Blood Platelet Disorders medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of thoracic surgery. 98(4) |
| ISSN: | 1552-6259 |
| Popis: | Shear stress-induced platelet dysfunction (PD) is prevalent among adults with aortic stenosis. Our aim was to determine whether abnormal platelet function was associated with specific congenital cardiac lesions in children.The charts of 407 children who had undergone cardiopulmonary bypass and had preoperative platelet function analysis were evaluated. Patients were assigned to 1 of 11 different lesion categories. Platelet dysfunction (PD) was defined as prolonged closure time (CT) as measured with a platelet function analyzer. Odds ratio (OR) estimates for prolonged CT were calculated for each lesion category. Mean CTs were compared with Tukey-Kramer separated means testing. Analysis of variance modeling was used to determine association between hematocrit value and CT.CT in patients with ventricular septal defects (VSD) and right ventricular outflow tract obstruction (RVOTO) lesions was prolonged. OR analysis found that patients with VSDs (OR, 2.46) or RVOTO (OR, 2.88) had at least a 95% probability of an abnormal CT. In contrast, patients with atrial septal defect (ASD), bidirectional Glenn procedure (BDG), and pulmonary insufficiency (PI) had a reduced probability of a prolonged CT (p 0.05). A similar pattern was seen in parametric analysis comparing mean CTs across lesion categories. A lower preoperative hematocrit value was associated with prolonged CTs across all lesion types (p0.05).PD was common in children with congenital cardiac lesions involving systolic flow abnormalities and was uncommon among children with lesions having diastolic abnormalities. Lower preoperative hematocrit values were associated with prolonged CTs, suggesting subclinical bleeding secondary to excessive platelet shearing. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|