Thrombin formation and effect of unfractionated heparin during pediatric cardiac catheterization

Abstract

Thrombin generation was enhanced in patients who did not receive UFH, which may increase the risk of thrombotic complications. In group A, routine heparinization seemed excessive by all monitoring methods. UFH prevented an increase in prothrombin to thrombin conversion, resulting in unaltered fibrin formation. The current UFH protocol seemed to have no effect on postprocedural activation of coagulation. Further studies are needed to clarify adequate heparin dosing for children during cardiac catheterization to prevent thrombotic complications without predisposing the patient to bleeding complications.

Cerebral microemboli detection and differentiation during transcatheter closure of atrial septal defect in a paediatric population

“…However, most procedures lasted <60 minutes, and the study population size does not allow for a statistical evaluation of the effect of antithrombotic prophylaxis in longer procedure times. In a recent paediatric study, however, the measured level of heparinisation correlated negatively with procedure time 31 …”

“…In a recent paediatric study, however, the measured level of heparinisation correlated negatively with procedure time. 31 A total of only 15 emboli, <0.1% of the total number detected, were not directly temporally related to a specific catheter or device manipulation. These signals, which we have determined to label as random, were instead detected during a period of occluder device preparation or, more commonly, following balloon inflation.…”