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Coagulation and Anticoagulation in Fontan Patients.

Coagulation and Anticoagulation in Fontan Patients.

Authors :
Heidendael JF
Engele LJ
Bouma BJ
Dipchand AI
Thorne SA
McCrindle BW
Mulder BJM
Source :
The Canadian journal of cardiology [Can J Cardiol] 2022 Jul; Vol. 38 (7), pp. 1024-1035. Date of Electronic Publication: 2022 Feb 03.
Publication Year :
2022

Abstract

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.<br /> (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1916-7075
Volume :
38
Issue :
7
Database :
MEDLINE
Journal :
The Canadian journal of cardiology
Publication Type :
Academic Journal
Accession number :
35122939
Full Text :
https://doi.org/10.1016/j.cjca.2022.01.028