title: Prevalence of cerebral and pulmonary thrombosis in patients with cyanotic congenital heart disease.
abstract: BACKGROUND
  Patients with cyanotic congenital heart disease (CCHD) have a high prevalence of thrombosis, the most frequently described locations being the cerebral and pulmonary vessels. The reported prevalence of both cerebral infarction and pulmonary thrombosis has been highly variable. The aim of this study was to examine the prevalence of both cerebral and pulmonary thrombosis in CCHD according to medical history and imaging. In addition, the role of known erythrocytosis and haemostatic abnormalities as risk factors was evaluated.
  
  
  RESULTS
  A cross-sectional descriptive study examining 98 stable adult patients with CCHD with a medical questionnaire, blood samples, MRI of the cerebrum (n=72), multidetector CT imaging (MDCT) of the thorax (n=76) and pulmonary scintigraphy (ventilation/perfusion/single-photon emission computerised tomography/CT) (n=66). The prevalence of cerebral infarction and pulmonary thrombosis according to imaging were 47% and 31%, respectively. Comparing the findings with previous medical history revealed a large under-reporting of thrombosis with only 22% of the patients having a clinical history of stroke and 25% of pulmonary thrombosis. There was no association between the degree of erythrocytosis or haemostatic abnormalities and the prevalence of thrombosis.
  
  
  CONCLUSIONS
  Patients with CCHD have a prevalence of both cerebral and pulmonary thrombosis of around 30%-40%, which is much higher than that reported previously. Furthermore, there is a large discrepancy between clinical history and imaging findings, suggesting a high prevalence of silent thrombotic events. Neither erythrocytosis nor haemostatic abnormalities were associated with the prevalence of thrombosis in patients with CCHD.
  
  
  BACKGROUND
  http://www.cvk.sum.dk/CVK/Home/English.aspx (H-KF-2006-4068).
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: A S
authors.initials: AS
authors.lastname: Jensen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Idorn
authors.affiliation: Department of Radiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Thomsen
authors.affiliation: Amager Radiological Clinic, Copenhagen, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: von der Recke
authors.affiliation: Department of Clinical Physiology & Nuclear Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Mortensen
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
authors.forename: K E
authors.initials: KE
authors.lastname: Sørensen
authors.affiliation: Department of Cardiology, Lund University Hospital, Lund, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Thilén
authors.affiliation: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Nagy
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: K F
authors.initials: KF
authors.lastname: Kofoed
authors.affiliation: Section for Transfusion Medicine, Capital Region Blood Bank, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: S R
authors.initials: SR
authors.lastname: Ostrowski
authors.affiliation: Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Søndergaard
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003490:Cyanosis / Q000175:diagnosis / Q000453:epidemiology*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D020767:Intracranial Thrombosis / Q000175:diagnosis / Q000453:epidemiology*; D008168:Lung / Q000098:blood supply*; D008279:Magnetic Resonance Imaging; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D055420:Perfusion Imaging; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013927:Thrombosis / Q000175:diagnosis / Q000453:epidemiology*; D015899:Tomography, Emission-Computed, Single-Photon