APPLICATION OF A NEW METHOD OF DIAGNOSING THROMBOHEMORRHAGIC DISORDERS IN CHILDREN WITH CONGENITAL HEART DISEASE

An insufficient level of prevention and correction disorders of hemostasis is connected with the absence of highly informative research methods of hemostasis.

The aim: to estimate efficacy and benefits of the study of rheological properties of blood using a method of low-frequency oscillation piezoelectric thromboelastography.

Materials and methods. The basic group is composed of 30 children with cyanotic cardiac anomalies (CCA), such cardiac anomalies as: tetralogy of fallot, total anomalous pulmonary venous connection, double outlet right ventricule, transposition of the great arteries. Oxygen saturation was 55–90%. The control group consisted of 30 patients with “pale” congenital heart disease (ventricular septal defect, atrial septal defect, patent ductus arteriosus).

Results and discussion. In the first group (CCA) chronometric parameters reflect hypercoagulation shifts vascular-platelet hemostasis. Similar changes were observed in the coagulation unit (increase performance KTA, VSK), although compared with the third group it was misleading. At the same time, the first group showed a significant decrease in the maximum density of the clot as compared to healthy children which can be further described as a cause of postoperative bleeding in the literature.

Conclusions. The nation’s first pediatric practice applied a new instrumental method of integral evaluation of the functional state of the hemostatic system. With the new method of diagnosis it is possible to estimate both vascular-platelet and coagulation hemostasis and fibrinolysis. The results of  examination of children with congenital heart disease showed marked changes of the hemostatic system, characterized by moderate chronometric hypercoagulability due to vascular-platelet and coagulation hemostasis.