caa a22 4500 445823690 CHVBK 20180317145252.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1007/s00246-010-9808-4 doi (NATIONALLICENCE)springer-10.1007/s00246-010-9808-4 Antiplatelet Versus Anticoagulation Therapy After Extracardiac Conduit Fontan: A Systematic Review and Meta-Analysis [Elektronische Daten] [Chiara Marrone, Gennaro Galasso, Raffaele Piccolo, Francesco de Leva, Rodolfo Paladini, Federico Piscione, Giuseppe Santoro] The benefits of prophylactic anticoagulation or antiplatelet therapy for patients undergoing extracardiac conduit (ECC) Fontan procedure still are a matter of debate. Through a systematic review and meta-analysis, this study aimed to determine the incidence of thromboembolism among patients undergoing ECC Fontan who received anticoagulation or antiplatelet therapy. Until February 2010, MEDLINE studies describing the incidence of thromboembolic events after ECC Fontan were reviewed. Information on type of drugs and clinical outcome was extracted. The 20 studies analyzed involved 1,075 patients: 220 (20.4%) in the antiplatelet group and 855 (79.5%) in the anticoagulation group. The mean follow-up period ranged from 2 to 144 months. The overall thromboembolism rate was 5.2% (95% confidence interval [CI], 3.8-7%; I2=0%; phet=0.32). The effect of different therapeutic strategies on the occurrence of thromboembolic and bleeding events was analyzed. Interestingly, the anticoagulation therapy compared with the antiplatelet therapy was not associated with a significant reduction in the incidence of overall thromboembolic complications (5% vs 4.5%, respectively; I2=0%; phet=0.80). Only two cases of bleeding were observed among patients receiving anticoagulant therapy at the time of the event. For patients undergoing ECC Fontan, the rate of thromboembolic and bleeding events associated with antiplatelet therapy is similar to that associated with anticoagulation therapy. Springer Science+Business Media, LLC, 2010 Anticoagulation nationallicence Antiplatelet nationallicence Fontan procedure nationallicence Stroke nationallicence Thromboembolism nationallicence Marrone Chiara Pediatric Cardiology Unit, Santobono-Pausilipon Hospital, Via M. Fiore 6, Naples, Italy aut Galasso Gennaro Department of Clinical Medicine, Cardiovascular Sciences and Immunology, Federico II University, Naples, Italy aut Piccolo Raffaele Department of Clinical Medicine, Cardiovascular Sciences and Immunology, Federico II University, Naples, Italy aut de Leva Francesco Pediatric Cardiology Unit, Santobono-Pausilipon Hospital, Via M. Fiore 6, Naples, Italy aut Paladini Rodolfo Pediatric Cardiology Unit, Santobono-Pausilipon Hospital, Via M. Fiore 6, Naples, Italy aut Piscione Federico Department of Clinical Medicine, Cardiovascular Sciences and Immunology, Federico II University, Naples, Italy aut Santoro Giuseppe Department of Pediatric Cardiology, Monaldi Hospital, Naples, Italy aut Pediatric Cardiology Springer-Verlag 32/1(2011-01-01), 32-39 0172-0643 32:1<32 2011 32 246 https://doi.org/10.1007/s00246-010-9808-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00246-010-9808-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Marrone Chiara Pediatric Cardiology Unit, Santobono-Pausilipon Hospital, Via M. Fiore 6, Naples, Italy aut NATIONALLICENCE 700 1- Galasso Gennaro Department of Clinical Medicine, Cardiovascular Sciences and Immunology, Federico II University, Naples, Italy aut NATIONALLICENCE 700 1- Piccolo Raffaele Department of Clinical Medicine, Cardiovascular Sciences and Immunology, Federico II University, Naples, Italy aut NATIONALLICENCE 700 1- de Leva Francesco Pediatric Cardiology Unit, Santobono-Pausilipon Hospital, Via M. Fiore 6, Naples, Italy aut NATIONALLICENCE 700 1- Paladini Rodolfo Pediatric Cardiology Unit, Santobono-Pausilipon Hospital, Via M. Fiore 6, Naples, Italy aut NATIONALLICENCE 700 1- Piscione Federico Department of Clinical Medicine, Cardiovascular Sciences and Immunology, Federico II University, Naples, Italy aut NATIONALLICENCE 700 1- Santoro Giuseppe Department of Pediatric Cardiology, Monaldi Hospital, Naples, Italy aut NATIONALLICENCE 773 0- Pediatric Cardiology Springer-Verlag 32/1(2011-01-01), 32-39 0172-0643 32:1<32 2011 32 246 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer