Pediatric Cardiology

, Volume 30, Issue 6, pp 771–776

Thromboelastography of Patients After Fontan Compared with Healthy Children

  • Leslie Raffini
  • Alexander Schwed
  • X. Long Zheng
  • Maria Tanzer
  • Susan Nicolson
  • J. William Gaynor
  • David Jobes
Original Article


Patients who have undergone a Fontan procedure face an increased risk for thromboembolic complications. This study aimed to evaluate whether thromboelastography, a global whole-blood assay of coagulation, can be used to detect hypercoagulability in pediatric Fontan patients compared with healthy children. This prospective, cross-sectional study investigated 25 Fontan patients and 51 healthy children in three age groups: 1–5 years, 6–10 years, and 11–16 years. Kaolin-activated thromboelastography was performed on citrated samples. No statistically significant differences in thromboelastography parameters were found among the different age groups of the 51 healthy children. None of the 25 Fontan patients demonstrated evidence of hypercoagulability on thromboelastography (95% confidence interval, 0–7%), as defined by two standard deviations above or below the normal mean. The findings suggest that the percentage of Fontan patients demonstrating hypercoagulability on thromboelastography is substantially lower than the reported incidence of thromboembolic complications. Whether thromboelastography could be helpful in predicting patients at increased risk for thromboembolic complications or not still is not known. Further studies comparing the thromboelastography of Fontan patients with the thromboembolic complications of those without Fontan are needed to delineate these issues.


CHD Fontan Hematology Thrombosis 


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Leslie Raffini
    • 1
  • Alexander Schwed
    • 2
  • X. Long Zheng
    • 3
  • Maria Tanzer
    • 3
  • Susan Nicolson
    • 4
  • J. William Gaynor
    • 5
  • David Jobes
    • 4
  1. 1.Division of Hematology, Department of PediatricsThe Children’s Hospital of Philadelphia, University of Pennsylvania School of MedicinePhiladelphiaUSA
  2. 2.University of Pennsylvania School of MedicinePhiladelphiaUSA
  3. 3.Department of Pathology and Laboratory MedicineThe Children’s Hospital of Philadelphia, University of Pennsylvania School of MedicinePhiladelphiaUSA
  4. 4.Division of Cardiac Anesthesia, Department of Anesthesia and Critical CareThe Children’s Hospital of Philadelphia, University of Pennsylvania School of MedicinePhiladelphiaUSA
  5. 5.Division of Cardiothoracic Surgery, Department of SurgeryThe Children’s Hospital of Philadelphia, University of Pennsylvania School of MedicinePhiladelphiaUSA

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