Severe thrombocytopenia in tetralogy of Fallot patients: A contraindication for corrective surgery?

Abstract

A 3-year-old boy with tetralogy of Fallot and recurrent cyanotic spells was found to have severe thrombocytopenia with platelet counts in the range of 11–30,000/mm 3 . There was a hesitation to operate in view of the high bleeding risk due to profound thrombocytopenia. However, the total correction was done after excluding other causes of thrombocytopenia. His platelet count dramatically improved after the operation.

<p>Reversible Hypoxia-Induced Thrombocytopenia in an Infant of Pulmonary Atresia with Ventricular Septal Defect</p>

“…These reports describe reversible thrombocytopenia in a 3-year-old boy and an 8-year-old girl following reoxygenation after operations. 5,6 To the best of our knowledge, our report describes the first case to show reversible hypoxia-induced thrombocytopenia in an infant.…”

“…Multiple etiologies of the thrombocytopenia have been suggested, such as impaired platelets, megakaryocyte production, increased platelet destruction, and increased platelet activation. [2][3][4][5][6] However, the cause of thrombocytopenia has not been clearly identified and conflicting data still exists regarding its etiology. 5,6 The PLT ranges widely based on the severity of the cyanosis and the amount of right-to-left shunt, which varies between patients.…”

“…[2][3][4][5][6] However, the cause of thrombocytopenia has not been clearly identified and conflicting data still exists regarding its etiology. 5,6 The PLT ranges widely based on the severity of the cyanosis and the amount of right-to-left shunt, which varies between patients. [2][3][4][5][6] PA with VSD is categorized as a CCHD.…”

“…5,6 The PLT ranges widely based on the severity of the cyanosis and the amount of right-to-left shunt, which varies between patients. [2][3][4][5][6] PA with VSD is categorized as a CCHD. However, our patient's SaO 2 averaged 80%, which is not considered severe cyanosis, and the duration of the hypoxia was less than 12 months.…”

Estimation of Prevalence of Thrombocytopenia in Cyanotic Congenital Heart Disease: A Cross-Sectional Study Among the Pediatric Population

“…In such cases, the exacerbation of right-to-left shunting, resulting in increased pulmonary circulation bypass, may impede the typical fragmentation of megakaryocytes within the lungs [ 4 ]. Thrombocytopenia is occasionally severe in cases of cyanotic heart diseases, and the patients are operated on despite the low platelet counts, which improve after the corrective surgery [ 5 ].…”