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J Thorac Cardiovasc Surg 1998;115:732-733
© 1998 Mosby, Inc.

LETTERS TO THE EDITOR

Coagulation abnormalities after Fontan procedures

Marjan Jahangiri, FRCS, Christopher Lincoln, FRCS

Reply to the Editor:

We are aware of the excellent work of Dr. Andrew in the field of coagulation in childhood. The normal ranges quoted in the article were provided by the Thrombosis Research Institute at the Royal Brompton Hospital. Drs. Monagle and Andrew have quoted a normal range for children between 1 and 5 years of age. In our study the median age at the time of the Fontan repair was 6.2 years and the median time from the Fontan repair to the time of the study was 4.9 years. The normal range for children 1 to 5 years old, therefore, is not applicable to all the patients in this group. Considering the normal range for 6- to 10-year-old and 11- to 16-year-old patients published by Andrew and associates,Go 1 the published results hold (Table I). We have not noted any recovery of these coagulation factors.


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  		Table I. Coagulation factors in 15 patients who had protein C and protein S levels below the normal range
 
None of the patients in the study had a history of thromboembolic episodes, and testing was not performed in the presence of active thrombus. This eliminates the chance for false positive results.

Department of Cardiac SurgeryRoyal Brompton Hospital
Imperial College of Science, Technologoy and MedicineSydney St.London SW3 6NP, United Kingdom References

  1. Andrew M, Vegh P, Johnston M, Bowker J, Ofosu F, Mitchell L. Maturation of the hemostatic system during childhood. Blood 1992;80:1998-2005.[Abstract/Free Full Text]



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