Thrombosis Prevention and Anticoagulation Management in the Pediatric Patient with Congenital Heart Disease

Eman Abdelghani; Clifford L Cua; Jean Giver; Vilmarie Rodriguez

doi:10.1007/s40119-021-00228-4

Thrombosis Prevention and Anticoagulation Management in the Pediatric Patient with Congenital Heart Disease

Cardiol Ther. 2021 Dec;10(2):325-348. doi: 10.1007/s40119-021-00228-4. Epub 2021 Jun 29.

Authors

Eman Abdelghani^{1

2}, Clifford L Cua^{3

4}, Jean Giver^{1

2}, Vilmarie Rodriguez^{1

2}

Affiliations

¹ Division of Pediatric Hematology/Oncology, Nationwide Children's Hospital, Columbus, OH, USA.
² Department of Pediatrics, The Ohio State University, Columbus, OH, USA.
³ Heart Center, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, USA. Clifford.Cua@nationwidechildrens.org.
⁴ Department of Pediatrics, The Ohio State University, Columbus, OH, USA. Clifford.Cua@nationwidechildrens.org.

Abstract

Thrombosis is one of the most frequent complications affecting children with congenital heart disease (CHD). Palliative and reparative cardiac surgeries are some of the main players contributing to the thrombosis risk in this patient population. Additional risk factors related to the CHD itself (e.g., cardiac dysfunction, arrhythmias, and polycythemia in cyanotic cardiac disorders) can contribute to thrombogenicity alone or combined with other factors. Thrombotic complications have been recognized as a significant cause of morbidity and mortality in this patient population. Here, we provide an overview of the pathophysiology and risk factors for thrombosis as well as the indications for and use of different anticoagulation, antiplatelet, and thrombolytic agents. In addition, we describe some of most common thrombotic complications and their management in the pediatric CHD population.

Keywords: Anticoagulation; Aspirin; Congenital heart disease; Heparin; Thrombosis; Warfarin.

Publication types

Review