Direct oral anticoagulant use and outcomes in adult patients with Fontan circulation: A multicenter retrospective cohort study

Kawamatsu, Naoto; Ishizu, Tomoko; Masuda, Keita; Horigome, Hitoshi; Takechi, Fumie; Tateno, Shigeru; Fukuda, Terunobu; Kijima, Yasufumi; Shiina, Yumi; Komiyama, Nobuyuki; Niwa, Koichiro; Hiramatsu, Yuji; Ieda, Masaki

doi:10.1016/j.ijcard.2020.11.024

Cited by 19 publications

(19 citation statements)

References 28 publications

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“…Seventy-four adult Fontan patients (mean age 32 years) using NOACs were studied in a multinational registry, reporting a TE rate of 2.9% per patient-year and a similar rate for major bleeding, which seemed comparable to event rates on VKAs from historical data (Figure 5) 52 . A retrospective study of adult Fontan patients (mean age 27 years) reported no TEs and an event rate of 0.6% per patient-year for major bleeding in 36 patients on NOACs, compared to 1.8% for TE and 1.9% for major bleeding in 42 patients on VKAs (p=NS) 53 .…”

Section: Vkas Versus Noacsmentioning

confidence: 99%

Coagulation and Anticoagulation in Fontan Patients

Heidendael

Engele

Bouma

et al. 2022

Canadian Journal of Cardiology

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Section: Vkas Versus Noacsmentioning

confidence: 99%

Coagulation and Anticoagulation in Fontan Patients

Heidendael

Engele

Bouma

et al. 2022

Canadian Journal of Cardiology

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“…The guidelines however do not specifically recommend the use of DOAC at present time given the scarcity of evidence in this area. Despite that, the published literature supports the safety and non-inferiority of DOAC when compared to warfarin in Fontan circulation patients [7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 98%

Recurrent Episodes of ST-Elevation Myocardial Infarction in a 19-Year-Old Male with Fontan Circulation

MA¹,

Sg²,

Ak³

et al. 2021

austinjclincardiolog

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We describe a case of a 19-year-old male with history of single ventricle physiology status post-Fontan procedure at the age of two who developed thromboembolic phenomena involving his splenic, renal and coronary arteries resulting in multiple infarcts and recurrent in-hospital acute ST-Segment Elevation Myocardial Infarction (STEMI) treated by emergent Percutaneous Coronary Intervention (PCI). This case highlights multiple aspects and challenges of managing young patients with congenital heart disease.

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“…Further analysis of this Fontan cohort nevertheless determined comparable rates of thromboembolism and major bleeding to VKAs as short-term thromboprophylaxis ( 74 ). A recent retrospective multicenter study by Kawamatsu et al consisting of 139 adult Fontan patients similarly proposed that DOACs may present benefits over VKAs in safety and efficacy, reducing the risk of thrombosis and hemorrhage ( 75 ).…”

Section: Thromboprophylaxis In the Fontan Populationmentioning

confidence: 99%

Increased Risk for Thromboembolism After Fontan Surgery: Considerations for Thromboprophylaxis

et al. 2022

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The Fontan circulation introduces an increased risk of thromboembolism which is associated with substantial mortality and morbidity. Adverse outcomes of thromboembolic complications post-Fontan surgery vary in both nature and severity, ranging from local tissue infarction and pulmonary embolism to Fontan failure and ischemic stroke. Furthermore, recent studies have identified that subclinical stroke is common yet underdiagnosed in Fontan patients. Fontan patients are commonly treated with antiplatelet agents and/or anticoagulants as primary thromboprophylaxis. Optimal thromboprophylaxis management in the Fontan population is still unclear, and clinical consensus remains elusive despite the growing literature on the subject. This perspective will describe the nature of thromboembolism post-Fontan surgery and provide evidence for the use of both current and emerging thromboprophylaxis options for children and adults living with Fontan circulation.

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Direct oral anticoagulant use and outcomes in adult patients with Fontan circulation: A multicenter retrospective cohort study

Cited by 19 publications

References 28 publications

Coagulation and Anticoagulation in Fontan Patients

Coagulation and Anticoagulation in Fontan Patients

Recurrent Episodes of ST-Elevation Myocardial Infarction in a 19-Year-Old Male with Fontan Circulation

Increased Risk for Thromboembolism After Fontan Surgery: Considerations for Thromboprophylaxis

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