Preoperative Evaluation of Hemostasis in Patients With Congenital Heart Disease

GERARDO COLON-OTERO, GERALD S. GILCHRIST, GERALD R. HOLCOMB, DUANE M. ILSTRUP, E. J.WALTER BOWIE

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53 Scopus citations

Abstract

The incidence of abnormal results of coagulation tests and the risks for postoperative hemorrhage were assessed in 235 patients with congenital heart disease. Preoperatively, the prothrombin time, partial thromboplastin time, activated partial thromboplastin time, thrombin time, or platelet count was abnormal in 45 of the 235 patients (19%), a significantly higher incidence than that expected in a normal population (P<0.002). Prolonged values for the prothrombin time or the partial thromboplastin time or activated partial thromboplastin time were seen most frequently. Further evaluation in eight of the patients with prolonged prothrombin time or partial thromboplastin or activated partial thromboplastin time showed decreased levels of either factor VII or IX in six of them, suggesting that impaired vitamin K-dependent carboxylation is commonly present. Normal results of preoperative coagulation tests do not exclude the presence of a major bleeding diathesis (von Willebrand's disease was later diagnosed in a patient with such findings). The use of blood products during subsequent cardiac operations was not significantly different in patients with normal or abnormal test results. Two of the three patients who required reoperation and were found to have a nonsurgical cause of bleeding had abnormalities in two or more of the preoperative coagulation tests. This finding suggests that abnormal results of preoperative coagulation tests may be predictive of defective hemostasis in the postoperative period.

Original languageEnglish (US)
Pages (from-to)379-385
Number of pages7
JournalMayo Clinic proceedings
Volume62
Issue number5
DOIs
StatePublished - Jan 1 1987

ASJC Scopus subject areas

  • Medicine(all)

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    COLON-OTERO, GERARDO., GILCHRIST, GERALD. S., HOLCOMB, GERALD. R., ILSTRUP, DUANE. M., & BOWIE, E. J. WALTER. (1987). Preoperative Evaluation of Hemostasis in Patients With Congenital Heart Disease. Mayo Clinic proceedings, 62(5), 379-385. https://doi.org/10.1016/S0025-6196(12)65442-1