Prophylactic Antiplatelet Therapy in Children with Cyanotic Heart Disease
Children with congenital cyanotic heart disease are prone to hemorrhagic as well as thrombo-embolic complications. Formerly it has been suggested that the alterations of the hemodynamics existing in this kind of disease caused continuous disseminated intravascular coagulation with consumption coagulopathy. More recent kinetic studies however showed that in cyanotic heart disease only the survival time of the thrombocytes is shortened while the fibrinogen consumption is normal (1, 3, 4). From the aspect of coagulation physiology we have a similar situation in the hemolytic uremic syndrome. Therefore we treat patients with hemolytic uremic syndrome not with anticoagulants but with antiplatelet drugs, in order to interrupt the vicious circle platelet induced thrombosis platelet → consumption → thrombocytic bleeding tendency (2). Best results were obtained with the combination of ASA (Aspirin) and Dipyridamol (Persantin) (1). The following is a report of our preliminary experiences with antiplatelet therapy in children with congenital cyanotic heart disease.
KeywordsAspirin Heparin Thrombocytopenia Fibrinogen Plasminogen
Unable to display preview. Download preview PDF.