Strategies for thromboprophylaxis in Fontan circulation: a meta-analysis

Heart
Tarek AlsaiedGruschen R Veldtman

Abstract

The Fontan circulation is associated with an increased risk of thromboembolic events (TEs). As many as 25% of these thrombotic events result in fatality. More subtle adverse effects on the pulmonary circulation from embolic thrombi may further impair adequate functioning of the circuit. Despite these well-documented phenomena, the most optimal approaches to thromboprophylaxis are still not clearly defined. A meta-analysis of published trials in English on PubMed and Cochrane libraries that evaluated the role of using TE prophylaxis in patients who underwent the Fontan procedure was conducted. 10 studies with a total number of 1200 patients with an average follow-up time of 7.1 years were identified. A random effect model was used. The incidence of TE was significantly less in patients who received TE prophylaxis (using either aspirin or warfarin) compared with patients who did not receive TE prophylaxis (OR 0.425, 95% CI 0.194 to 0.929, p<0.01, I(2)=37%). The incidence of TE was significantly lower in patients who received aspirin compared with no TE prophylaxis (OR 0.363, 95% CI 0.177 to 0.744, p<0.01, I(2)=0%) and who received warfarin compared with no TE prophylaxis (OR 0.327, 95% CI 0.168 to 0.634, p<0.01, I(2)=2.5%). There...Continue Reading

References

Nov 1, 1995·Circulation·D N RosenthalW E Hellenbrand
Jun 1, 1997·The Journal of Thoracic and Cardiovascular Surgery·M JahangiriE Shinebourne
Apr 16, 1998·The Journal of Thoracic and Cardiovascular Surgery·P MonagleM Andrew
Jun 17, 2000·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·G S HaasJ A van Son
Aug 14, 2002·The Annals of Thoracic Surgery·Ralf G SeipeltEberhard G Mühler
Mar 5, 2005·The Journal of Thoracic and Cardiovascular Surgery·Renate KaulitzMichael Hofbeck
Jun 17, 2005·Heart·H A Walker, M A Gatzoulis
Jul 12, 2005·International Journal of Cardiology·Y F CheungL C Cheng
May 16, 2006·Journal of the American College of Cardiology·Salvatore GiannicoStephen P Sanders
Sep 14, 2007·Circulation·Yves d'UdekemChristian P Brizard
Dec 21, 2007·Cardiology in the Young·Maria A BinottoAntonio A Lopes
Jul 4, 2008·Cleveland Clinic Journal of Medicine·Esteban WalkerMichael W Kattan
Jul 30, 2009·Circulation Journal : Official Journal of the Japanese Circulation Society·Hidemi KajimotoToshio Nakanishi
Jul 30, 2011·Journal of the American College of Cardiology·Paul MonagleUNKNOWN Fontan Anticoagulation Study Group
Apr 20, 2012·The Journal of Pediatrics·Cedric ManlhiotBrian W McCrindle
Feb 13, 2013·Thrombosis Research·Elizabeth CroneSophie Jones
Mar 12, 2013·The Canadian Journal of Cardiology·Blandine MondésertPaul Khairy
Jul 31, 2013·The Journal of Thoracic and Cardiovascular Surgery·Lidia Tomkiewicz-PajakAnetta Undas
Nov 15, 2013·Circulation·Therese M GigliaUNKNOWN American Heart Association Congenital Heart Defects Committee of the Council on Cardiovascular Disease in the Young, Council
Dec 10, 2013·Lancet·Torben Bjerregaard Larsen, Gregory Y H Lip
Apr 11, 2014·Cardiovascular Ultrasound·Lidia Tomkiewicz-PajakPiotr Podolec
Sep 24, 2014·International Medical Case Reports Journal·Khalid A BinyminDipti Patel
Sep 24, 2014·Congenital Heart Disease·Christopher A ThomasAlexandre T Rotta

❮ Previous
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Citations

May 28, 2016·Congenital Heart Disease·Munes FaresTarek Alsaied
Sep 15, 2016·Annals of Pediatric Cardiology·Sangeetha Viswanathan
Sep 7, 2016·Congenital Heart Disease·Camden HebsonMichael McConnell
Apr 8, 2017·The American Journal of Cardiology·Kiona Y AllenDavid J Goldberg
Aug 27, 2016·Asian Cardiovascular & Thoracic Annals·Takahiko SakamotoKenji Yamazaki
Aug 31, 2018·World Journal for Pediatric & Congenital Heart Surgery·Adam J SmallGentian Lluri
Oct 11, 2017·Circulation·George K LuiUNKNOWN American Heart Association Adult Congenital Heart Disease Committee of the Council on Clinical Cardiology and Council on Car
Jan 7, 2018·BMJ Case Reports·Katherine VanHiseNiamh Condon
Jun 13, 2020·Journal of Clinical Medicine·Nikolaos StalikasGeorge Giannakoulas
May 30, 2020·Cardiology in the Young·Amrit MisraPooja Gupta
Jul 14, 2018·F1000Research·Jelle P G van der VenWillem A Helbing
Apr 22, 2017·Journal of Thrombosis and Thrombolysis·Jenna M FairclothGruschen R Veldtman
Aug 2, 2017·Journal of Thrombosis and Thrombolysis·Jenna M FairclothGruschen R Veldtman
Jun 28, 2018·Pediatric Cardiology·D E SegarI H Law
Dec 4, 2019·Heart Failure Reviews·Rose Tompkins, Anitra Romfh
Feb 9, 2020·Journal of Clinical Medicine·Tarek AlsaiedJohnathan R Dillman
Oct 11, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Clément KarsentyMagalie Ladouceur
Jan 13, 2021·Cardiology in the Young·May Al-ShawkAmer Harky
Aug 17, 2019·Journal of Molecular and Cellular Cardiology·Anita SarafChunhui Xu
Jan 15, 2021·Seminars in Thoracic and Cardiovascular Surgery·Ashish A AnkolaArthur J Smerling
Feb 18, 2021·The Journal of Thoracic and Cardiovascular Surgery·Adam M Lubert, Andrew N Redington
Feb 15, 2021·The Journal of Thoracic and Cardiovascular Surgery·Michael Daley, Yves d'Udekem
Jan 17, 2021·American Journal of Obstetrics & Gynecology MFM·Natasha K WolfeKathryn J Lindley
Mar 5, 2021·Seminars in Thoracic and Cardiovascular Surgery·Erle H Austin
Apr 29, 2021·AJR. American Journal of Roentgenology·Govind B ChavhanGeetika Khanna
May 4, 2021·Clinical Case Reports·Toshihiko KakiuchiMuneaki Matsuo
May 12, 2021·Open Heart·Joelle Julius Nicolaas DaemsVera Ignjatovic
May 25, 2021·International Anesthesiology Clinics·Samantha F LuJennifer M Banayan
May 24, 2021·Journal of Cardiothoracic and Vascular Anesthesia·John Richard McNamaraMichael Griffin
Jun 29, 2021·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Iqbal El AssaadDouglas Y Mah
Sep 25, 2021·Journal of the American Heart Association·Brian W McCrindleUNKNOWN UNIVERSE Study Investigators *

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