Prolonged bleeding time associated with acyanotic congenital heart disease.

Abstract

Acyanotic congenital heart diseases with prolonged bleeding time, normal platelet count and normal clotting time were encountered in 18 of 128 cases of acyanotic congenital heart diseases. And the hemostatic tests were per-formed in 14 cases. Major abnormalities in the hemostatic tests were impaired prothrombin consumption, platelet adhesiveness and activity of platelet factor 3. So these bleeding tendencies were thought to be chiefly caused by thrombocyte dysfunction. By the postoperative hemostatic tests, shortening of bleeding time, and improvement of prothrombin consumption, platelet adhesiveness and platelet factor 3 activity were recognized in several cases, though activities of factor VIII and IX showed no changes. These bleeding tendencies occurred frequently in a group of heart diseases such as ventricular septal defect, patent ductus arteriosus and pulmonary stenosis, in which turbulences of blood flow with high gradient of pressure were apt to occur. Considering the postoperative improvement and the frequency of occurrence, one of the important factors of these bleeding tendencies would be the secondary platelet dysfunction due to hemodynamic disorders of heart diseases. Generally, these bleeding tendencies have no close relation to the post-operative bleeding, when fresh blood transfusion is used and cautious hemostasis is carried out during operation.