Jahnavi Sarma
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Written By: Jahnavi Sarma | Updated : February 17, 2021 8:28 AM IST
Blood clots are dangerous because they can cause the heart to fail or lead to a stroke. For this reason, all patients are given blood thinning medications.
Fontane surgery is a complex congenital heart disease operation redirecting blood flow from the lower body to the lungs. It is offered to children born with severe heart defects, allowing the child to live with just one pumping heart chamber instead of two. This procedure is the last stage operation for kids who are born with congenital heart disease and who cannot be offered a 2-ventricle repair. Although the operation couldn't completely 'fix' the heart, most were able to live well into adulthood and have relatively normal lives. But one side effect of this procedure is that those who have the procedure were at an increased risk for blood clots. According to experts, there are about 70,000 post-Fontan patients alive today, and this number is expected to double within two decades.
Now, according to a new research led by the Murdoch Children's Research Institute (MCRI) Aspirin should be favoured over warfarin to prevent blood clotting in children who undergo a surgery that replumbs their hearts. The Journal of Thoracic and Cardiovascular Surgery published this study.
This is basically a kind of open-heart surgery. It redirects blood from the lower part of the body directly to the lungs. The purpose of this procedure is to let blood pick up oxygen without having to pass through the heart. In babies with a congenital heart condition called hypoplastic left heart syndrome, low-oxygen blood from the lower part of the body mixes with high-oxygen blood. However, after the Fontane procedure, low-oxygen blood and high-oxygen blood no longer mix and only high-oxygen blood courses through the body.
Blood clots are dangerous because they can cause the heart to fail or lead to a stroke. For this reason, all patients are given blood thinning medications, with warfarin and aspirin being the most commonly prescribed ones.
According to researchers, warfarin comes with a few drawbacks. It can be affected by food, other medications and illness. So patients on this drug must have regular blood tests to check that their warfarin levels are safe. For the study, researchers looked at 121 patients enrolled in the Australian and New-Zealand Fontan (ANZ) Registry. They saw that stroke was common regardless of which medication the patient took. But patients on warfarin had poorer bone mineral density and were at a higher risk of bleeding.
Researchers said that for patients who undergo the Fontan procedure, and who do not have any additional blood clotting risk factors, aspirin should be offered over warfarin. According to them, given the need for regular INR monitoring of warfarin, a shift to aspirin would also have a cost benefit to the patient and the healthcare system. Aspirin is also easier to manage and would benefit many families whose children required the procedure in future.
(With inputs from Agencies)
