PMID- 17125503
OWN - NLM
STAT- MEDLINE
DCOM- 20070326
LR  - 20181113
IS  - 1466-609X (Electronic)
IS  - 1364-8535 (Print)
IS  - 1364-8535 (Linking)
VI  - 10
IP  - 6
DP  - 2006
TI  - Children undergoing cardiac surgery for complex cardiac defects show imbalance 
      between pro- and anti-thrombotic activity.
PG  - R165
AB  - INTRODUCTION: Cardiac surgery with cardiopulmonary bypass (CPB) is associated 
      with the activation of inflammatory mediators that possess prothrombotic activity 
      and could cause postoperative haemostatic disorders. This study was conducted to 
      investigate the effect of cardiac surgery on prothrombotic activity in children 
      undergoing cardiac surgery for complex cardiac defects. METHODS: Eighteen 
      children (ages 3 to 163 months) undergoing univentricular palliation with total 
      cavopulmonary connection (TCPC) (n = 10) or a biventricular repair (n = 8) for 
      complex cardiac defects were studied. Prothrombotic activity was evaluated by 
      measuring plasma levels of prothrombin fragment 1+2 (F1+2), thromboxane B2 
      (TxB2), and monocyte chemoattractant protein-1 (MCP-1). Anti-thrombotic activity 
      was evaluated by measuring levels of tissue factor pathway inhibitor (TFPI) 
      before, during, and after cardiac surgery. RESULTS: In all patients, cardiac 
      surgery was associated with a significant but transient increase of F1+2, TxB2, 
      TFPI, and MCP-1. Maximal values of F1+2, TxB2, and MCP-1 were found at the end of 
      CPB. In contrast, maximal levels of TFPI were observed at the beginning of CPB. 
      Concentrations of F1+2 at the end of CPB correlated negatively with the minimal 
      oesophageal temperature during CPB. Markers of prothrombotic activity returned to 
      preoperative values from the first postoperative day on. Early postoperative TFPI 
      levels were significantly lower and TxB2 levels significantly higher in patients 
      with TCPC than in those with biventricular repair. Thromboembolic events were not 
      observed. CONCLUSION: Our data suggest that children with complex cardiac defects 
      undergoing cardiac surgery show profound but transient imbalance between pro- and 
      anti-thrombotic activity, which could lead to thromboembolic complications. These 
      alterations are more important after TCPC than after biventricular repair but 
      seem to be determined mainly by low antithrombin III.
FAU - Heying, Ruth
AU  - Heying R
AD  - Department of Pediatric Cardiology, University Hospital, RWTH-Aachen, 
      Pauwelsstrasse 30, 52074 Aachen, Germany. heying@uni-duesseldorf.de
FAU - van Oeveren, Wim
AU  - van Oeveren W
FAU - Wilhelm, Stefanie
AU  - Wilhelm S
FAU - Schumacher, Katharina
AU  - Schumacher K
FAU - Grabitz, Ralph G
AU  - Grabitz RG
FAU - Messmer, Bruno J
AU  - Messmer BJ
FAU - Seghaye, Marie-Christine
AU  - Seghaye MC
LA  - eng
PT  - Journal Article
PL  - England
TA  - Crit Care
JT  - Critical care (London, England)
JID - 9801902
RN  - 9000-94-6 (Antithrombin III)
SB  - IM
MH  - Antithrombin III/analysis
MH  - *Blood Coagulation
MH  - Blood Coagulation Tests
MH  - Cardiac Surgical Procedures/*adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Heart Bypass, Right/*adverse effects
MH  - Heart Defects, Congenital/*surgery
MH  - Humans
MH  - Prospective Studies
MH  - Thrombosis/etiology/*physiopathology
PMC - PMC1794476
EDAT- 2006/11/28 09:00
MHDA- 2007/03/27 09:00
PMCR- 2006/11/24
CRDT- 2006/11/28 09:00
PHST- 2006/08/31 00:00 [received]
PHST- 2006/11/05 00:00 [revised]
PHST- 2006/11/24 00:00 [accepted]
PHST- 2006/11/28 09:00 [pubmed]
PHST- 2007/03/27 09:00 [medline]
PHST- 2006/11/28 09:00 [entrez]
PHST- 2006/11/24 00:00 [pmc-release]
AID - cc5108 [pii]
AID - 10.1186/cc5108 [doi]
PST - ppublish
SO  - Crit Care. 2006;10(6):R165. doi: 10.1186/cc5108.