Document Type

Article

Publication Date

4-30-2026

Abstract

2. Structured summary:

A. Background: Patients with cyanotic congenital heart disease exhibit coagulation abnormalities related to chronic hypoxemia, which may increase the risk of bleeding and thrombosis, particularly during cardiopulmonary bypass.

B. Objective: This scoping review mapped the existing literature on coagulation disturbances and perioperative hemostatic outcomes in pediatric patients with cyanotic congenital heart disease.

C. Methods: 14 studies meeting the inclusion criteria were identified through structured database searching. The data were collected and synthesized descriptively due to heterogeneity in study design, patient populations, and coagulation assessment methods.

D. Results: Across studies, cyanotic patient physiology was associated with platelet dysfunction, clotting factor abnormalities, and hypocoagulable viscoelastic profiles, particularly after cardiopulmonary bypass. Increased transfusion requirements and postoperative bleeding were commonly reported, and thrombotic events were documented in select populations.

E. Conclusions: The available literature indicates clinically relevant perioperative hemostatic instability in patients with cyanotic congenital heart disease. Further standardized prospective research is needed to guide evidence-based management strategies.

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