Coagulation in Cyanotic Congenital Heart Disease

A comprehensive study of the hemostatic status of 33 patients with cyanotic congenital heart disease and nine patients with acyanotic heart disease was undertaken to define the types of coagulation abnormalities present in cardiac patients prior to surgery. Evidence of disseminated intravascular coagulation was sought, but never found. Thrombocytopenia was the most frequent abnormality and was directly related to the degree of polycythemia. Abnormalities of many coagulation factors existed in patients having hematocrit values above 60%. Because of the variability in the coagulation factor levels in patients with similar hematocrit readings, each child must be studied and considered separately prior to surgery. The therapeutic success of surgery can be compromised by complications of postoperative hemorrhage or thrombosis or both.