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Risk factors of thrombotic complications in patients with single functional ventricle

https://doi.org/10.21508/1027-4065-2019-64-2-68-74

Abstract

Objective: to analyze the parameters of the hemostasis system and the results of molecular genetic testing in patients with a single functional ventricle. The study included 102 patients. All the patients underwent a staged surgical hemodynamic correction of a single functional ventricle. The authors performed a retrospective analysis of patient records in order to identify the episodes of thrombosis. The incidence of thrombotic complications at different stages of hemodynamic correction in the examined patients with a single functional ventricle was 12.7%. The indicators of plasma link hemostasis in the observed patients have been characterized by a balance of hemostatic reactions in the group of children with thrombosis and without. The results of a molecular genetic study demonstrated that the carrier of the heterozygous genotype of 20210GA factor II gene in patients with a single functional ventricle increased the risk of thrombotic complications 16 times (15.4% in patients with thrombosis versus 1.1% in the group without thrombosis; odds ratio 16.0; 95% confidence interval 1.34–191.24; p=0.028). All patients with thrombosis in the history revealed a homozygous condition according to variant 10976GG factor VII gene (p=0.017).
Conclusion: molecular genetic analysis of polymorphic variants of the hemostatic system in patients with a single functional ventricle is required to predict the risk, timely prevention and correction of thrombotic complications during the surgical treatment of congenital heart disease.

About the Authors

Yu. G. Lugacheva
Scientific and Research Institute for Cardiology “Tomsk National Research Medical Center”
Russian Federation
Tomsk


I. V. Kulagina
Scientific and Research Institute for Cardiology “Tomsk National Research Medical Center”
Russian Federation
Tomsk


I. A. Kovalev
Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University
Russian Federation
Moscow


Ye. V. Krivoschekov
Scientific and Research Institute for Cardiology “Tomsk National Research Medical Center”
Russian Federation
Tomsk


O. S. Yanulevich
Scientific and Research Institute for Cardiology “Tomsk National Research Medical Center”
Russian Federation
Tomsk


T. E. Suslova
Scientific and Research Institute for Cardiology “Tomsk National Research Medical Center”
Russian Federation
Tomsk


References

1. Van Brakel T., Schoof P., de Roo F., Nikkels P., Evens F., Haas F. High incidence of dacron conduit stenosis for extracardiac Fontan procedure. J Thorac Cardiovasc Surg 2014; 147(5): 1568–1572. DOI: 10.1016/j.jtcvs.2013.07.013

2. Zhdanova L.V., Patrushev L.I., Dolgikh V.V. Polymorphism of genes responsible for thrombophilia and their influence on the development of thrombosis in childhood. Byulleten’ Vostochno-Sibirskogo nauchnogo tsentra Sibirskogo otdeleniya Rossijskoj akademii meditsinskikh nauk (Bulletin of the East Siberian scientific center of the Siberian branch of the Russian Academy of medical Sciences) 2013; 92(4): 115–118. (in Russ)

3. Yang J.Y., Chan A.K. Pediatric thrombophilia. Pediatr Clin N Am 2013; 60(6): 1443–1462. DOI: 10.1016/j.pcl.2013.09.004.

4. Alioglu B., Avci Z., Tokel K., Atac F., Ozbek N. Thrombosis in children with cardiac pathology: analysis of acquired and inherited risk factors. Blood Coagul Fibrinolysis 2008; 19(4): 294–304. DOI: 10.1097/MBC.0b013e3282fe73b1

5. Malbora B., Özbek N., Avci Z., Verdi H. , Alioglu B., Varan B., Atac F. Role of Thrombophilic Mutations in Childhood Cardiac and Great Vessel Thrombosis. J Pediatr Sci 2014; 6(218): 1–9. DOI: 10.17334/jps.89654

6. Ganeshakrishnan K.T., Van Arsdell G.S., Dicke F.P., McCrindle B.W., Coles J.G. et al. Are bilateral superior vena cavae a risk factor for single ventricle palliation? Ann Thorac Surg 2000; 70: 711–716. DOI: 10.1016/S0003-4975(00)01627-1

7. Coon P.D., Rychik J., Novello R.T. Gaynor J.W., Spray T.L. Thrombus formation after the Fontan operation. Ann Thorac Surg 2001; 71(6): 1990–1994.

8. Jahangiri М., Kreutzer J., Zurakowski D., Bacha E., Jonas R.A. Evaluation of hemostatic and coagulation factor abnormalities in patients undergoing the Fontan operation. J Thorac Cardiovasc Surg 2000; 120(4): 778–782. DOI: 10.1067/mtc.2000.108903

9. Chaloupecky V., Svobodova I., Hadacova I., Tomek V., Hučín B., Tláskal T. et al. Coagulation profile and liver function in 102 patients after total cavopulmonary. Heart 2005; 91(1): 73–81. DOI: 10.1136/hrt.2003.026419

10. Konstantinov I.E., Puga F.J., Alexi-Meskishvili V.V. Thrombosis of intracardiac or extracardiac conduits after modified Fontan operation in patients with azygous continuation of the inferior vena cava. Ann Thorac Surg 2001; 72: 1641–1644.

11. Belousova T.V., Anmut S.Ya., Plyushkin V.A. Aseptic cerebral venous thrombosis in a newborn with hereditary thrombophilia. Sibirskoe meditsinskoe obozrenie 2014; 87(3): 85–87. (in Russ)

12. Zharkov P.A., Roitman E.V., Svirin P.V. et al. Influence of prothrombotic polymorphisms on the risk of venous thrombosis in children. Gematologiya i transfuziologiya (Hematology and Transfusiology) 2012; 57(4): 27–32. (in Russ)

13. Albisetti M., Moeller A., Waldvodel K., Bernet V. Congenital prothrombotic disordes in children with peripheral venous and arterial thromboses. Acta Haematol 2007; 117(3): 149–155. DOI: 10.1159/000097462

14. Laugesaar R., Kahre T., Kolk A., Uustalu Ü., Kool P., Talvik T. Factor V Leiden and prothrombin 20210G >A [corrected] mutation and paediatric ischaemic stroke: a case-control study and two meta-analyses. Acta Paediatr 2010; 99(8): 1168–1174. DOI: 10.1111/j.1651-2227.2010.01784.x

15. L`vova O.A., Kovtun O.P., Chegodaev D.A. Genetically determined disorders of blood coagulation as a cause of ischemic strokes in children. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova (S.S. Korsakov Journal of Neurology and Psychiatry) 2011; 12(2): 3–9. (in Russ)

16. Ogawa M., Abe S., Biro S., Saigo М., Kihara T., Setoyama S. et al. R353Q Polymorphism, Activated Factor VII, and Risk of Premature Myocardial Infarction in Japanese Men. Circulation 2004; 68(6): 520–525. DOI: 10.1253/circj.68.520


Review

For citations:


Lugacheva Yu.G., Kulagina I.V., Kovalev I.A., Krivoschekov Ye.V., Yanulevich O.S., Suslova T.E. Risk factors of thrombotic complications in patients with single functional ventricle. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2019;64(2):68-74. (In Russ.) https://doi.org/10.21508/1027-4065-2019-64-2-68-74

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ISSN 1027-4065 (Print)
ISSN 2500-2228 (Online)