PMID- 29277101
OWN - NLM
STAT- MEDLINE
DCOM- 20180911
LR  - 20200225
IS  - 1938-2723 (Electronic)
IS  - 1076-0296 (Print)
IS  - 1076-0296 (Linking)
VI  - 24
IP  - 3
DP  - 2018 Apr
TI  - Incidence and Management of Thrombotic and Thromboembolic Complications Following 
      the Superior Cavopulmonary Anastomosis Procedure: A Literature Review.
PG  - 405-415
LID - 10.1177/1076029617739702 [doi]
AB  - The objective of this literature review was to estimate the incidence of 
      thrombosis and thromboembolism associated with the superior cavopulmonary 
      anastomosis (SCPA) procedure and its variants and to examine current 
      thromboprophylaxis regimens utilized. MEDLINE and EMBASE were searched from 
      inception to August 2017 for all prospective and retrospective cohort studies 
      explicitly reporting incidence of thrombosis, thromboembolism, or shunt occlusion 
      in neonates, infants, and children undergoing 1 or more variants of the SCPA 
      procedure. End points included thrombotic events and thromboembolic events 
      (strokes and pulmonary embolisms) as primary outcomes, and overall mortality as a 
      secondary outcome, at the last available follow-up time point. Of 1303 unique 
      references identified, 13 cohort studies were deemed eligible. Reported incidence 
      of thrombosis and thromboembolic events ranged from 0% to 28.0% and from 0% to 
      12.5%, respectively. Reported incidence of major bleeding events ranged from 0% 
      to 2.9%. Reported overall mortality ranged from 2.5% to 50.5% across studies. 
      Thromboprophylaxis protocols varied across institutions and studies, most 
      commonly involving unfractionated heparin (UFH), warfarin, enoxaparin, 
      acetylsalicylic acid (ASA), or combinations of ASA and warfarin, ASA and 
      low-molecular-weight heparin (LMWH), UFH and LMWH, and UFH and ASA; several 
      studies did not specify a protocol. Due to substantial variability in reported 
      event rates, no clear correlation was identified between prophylaxis protocols 
      and postoperative thrombotic complications. Despite guidance recommending 
      postoperative UFH as standard practice, thromboprophylaxis protocols varied 
      across institutions and studies. More robust trials evaluating different 
      thromboprophylaxis regimens for the management of these patients are warranted.
FAU - Agarwal, Arnav
AU  - Agarwal A
AD  - 1 Department of Pediatrics, McMaster Children's Hospital, McMaster University, 
      Hamilton, Ontario, Canada.
AD  - 2 School of Medicine, University of Toronto, Toronto, Ontario, Canada.
FAU - Firdouse, Mohammed
AU  - Firdouse M
AD  - 1 Department of Pediatrics, McMaster Children's Hospital, McMaster University, 
      Hamilton, Ontario, Canada.
AD  - 2 School of Medicine, University of Toronto, Toronto, Ontario, Canada.
FAU - Brar, Nishaan
AU  - Brar N
AD  - 2 School of Medicine, University of Toronto, Toronto, Ontario, Canada.
FAU - Yang, Andy
AU  - Yang A
AD  - 3 Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, 
      Canada.
FAU - Lambiris, Panos
AU  - Lambiris P
AD  - 4 University Health Network Library and Information Services, Toronto General 
      Hospital, Toronto, Ontario, Canada.
FAU - Chan, Anthony K
AU  - Chan AK
AD  - 1 Department of Pediatrics, McMaster Children's Hospital, McMaster University, 
      Hamilton, Ontario, Canada.
FAU - Mondal, Tapas Kumar
AU  - Mondal TK
AD  - 1 Department of Pediatrics, McMaster Children's Hospital, McMaster University, 
      Hamilton, Ontario, Canada.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20171225
PL  - United States
TA  - Clin Appl Thromb Hemost
JT  - Clinical and applied thrombosis/hemostasis : official journal of the 
      International Academy of Clinical and Applied Thrombosis/Hemostasis
JID - 9508125
SB  - IM
MH  - Disease Management
MH  - Heart Bypass, Right/*adverse effects
MH  - Humans
MH  - Incidence
MH  - Thromboembolism/etiology/prevention & control
MH  - Thrombosis/etiology/prevention & control
PMC - PMC6714653
OTO - NOTNLM
OT  - bidirectional Glenn
OT  - hemi-Fontan
OT  - literature review
OT  - prophylaxis
OT  - superior cavopulmonary anastomosis
OT  - thromboembolism
OT  - thrombosis
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2017/12/27 06:00
MHDA- 2018/09/12 06:00
PMCR- 2017/12/25
CRDT- 2017/12/27 06:00
PHST- 2017/12/27 06:00 [pubmed]
PHST- 2018/09/12 06:00 [medline]
PHST- 2017/12/27 06:00 [entrez]
PHST- 2017/12/25 00:00 [pmc-release]
AID - 10.1177_1076029617739702 [pii]
AID - 10.1177/1076029617739702 [doi]
PST - ppublish
SO  - Clin Appl Thromb Hemost. 2018 Apr;24(3):405-415. doi: 10.1177/1076029617739702. 
      Epub 2017 Dec 25.