The present study was conducted to analyze the features and risk factors of childhood thrombotic events in patients with cardiac defect followed-up at our hospital. The clinical and laboratory findings of 59 patients diagnosed with cardiac defects and
thromboses between 1997 and 2006 were retrospectively analyzed. Thirty-one children (52.5%) had venous system
thromboses, 21 (35.6%) had arterial system
thromboses, and seven (11.9%) had venous and arterial system
thromboses. Presence of
congenital heart disease and
cardiomyopathy (
CMP) were significant risk factors for developing intracardiac
thrombosis. In addition, presence of
congenital heart disease was the significant statistical risk factor for developing left atrium and right ventricle
thromboses. Presence of
congenital heart disease was a significant risk factor for developing a central nervous system
thrombosis. Presence of
pulmonary stenosis and
aortic coarctation were significant risk factors for developing a peripheral arterial system
thrombosis. Acquired risk factors including major surgery, angiography,
central venous catheter, systemic
infection, and
hypoxia were identified in 49 of the 59 patients. Many patients had more than one of these acquired risk factors. Analysis of the relationship between
thrombosis and type of major surgery demonstrated a statistically significant relationship between an intracardiac
thrombosis and total correction of
tetralogy of Fallot and a peripheral venous system
thrombosis and a
Blalock Taussig shunt. Twenty-three of the 52 patients (44.2%) had at least one thrombophilic mutation. Overall, a heterozygous
factor V Leiden mutation was found in nine patients (17.3%), a
methylenetetrahydrofolate reductase 677C-T mutation in 15 patients (28.8%), and a PT 20210G-A mutation in three patients (5.8%). Our data suggest that cardiac defects are common risk factors for developing a childhood
thrombosis. The type of disorder determines the site of
thrombosis. Acquired risk factors may contribute to the development of a
thrombosis. The results of this study also indicate that to ensure early diagnosis, routine screening for
thrombosis should be performed in patients with a cardiac defect and that screening for
factor V Leiden and PT 20210G-A mutations and other genetic risk factors should be included when assessing all patients with cardiac defects who present with a
thrombosis, whether or not a predisposing factor has been identified.