PREVENTION OF THROMBOEMBOLISM IN CHILDREN WITH “CYANOTIC” CONGENITAL HEART AFTER PALLIATIVE SURGERY
Keywords:
“cyanotic” congenital heart disease, palliative surgery, hemostasis system, low-frequency piezoelectric thromboelastographyAbstract
Actuality. According to the literature data the frequency of thromboembolic complications in children with “cyanotic” congenital heart disease (CHD) after palliative surgery ranges from 1 to 20 % of cases. That is why the system of hemostasis in these patients deserves special attention. The aim — to investigate the hemostatic system in children with “cyanotic” CHD, which planned a palliative surgery in the preoperative and postoperative periods, and to estimate efficacy of the prevention of thromboembolic complications. Materials and methods. We studied 14 patients with “cyanotic” CHD, which planned a palliative surgery. The study was conducted using low-frequency piezoelectric thromboelastography (LPTEG) during hospitalization, after the operation, on the first postoperative day, after the anticoagulant heparin (on postoperative day 4) and at discharge. Indicators LPTEG compared with healthy children. Results. At the end of surgery, patients in this category require hemostatic therapy because it showed signs of structural and chronometric hypocoagulation. On the next day of the postoperative period after the stabilization of hemostasis we conducted anticoagulant therapy. At dischargein children with “cyanotic” CHD, indicators LPTEG did not differ significantly from that of healthy children. Conclusions. Management of anticoagulant therapy allowed us to prevent the development of thromboembolic complications.
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