Pediatric thrombotic events: a single-center study.

Recent literature has reported an apparent increase in the incidence of pediatric venous thromboembolism over the last 10 years. In our study, data were collected from all children (ages 0 to 18 y) with a thrombotic event between January 2000 and May 2012, to determine whether an increased incidence of thromboembolism (TE) was evident and to investigate mitigating factors in the development of the TE. A total of 134 patients were entered into the study, 42% under the age of 1 year. There was no conclusive evidence of an increased incidence in our population over the period of the study. Within our population the peripheral venous system was the most common location for TE followed by cerebral vascular accidents. A thrombophilic risk factor was found in 84% of the patients. In our study 4.5% of the children had a second event.

Chronic thromboembolic pulmonary hypertension: treat the patient not the haemodynamics.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a disabling condition that is being increasingly recognised. It is unique as a cause of pulmonary hypertension in that it is surgically curable. We wish to highlight the importance of recognition and early referral of any patient who may have CTEPH even in the absence of resting pulmonary hypertension as excellent results can be achieved by restoring pulmonary vascular anatomy, reducing exercise-induced pulmonary hypertension, and reducing dead-space ventilation. We present a case that illustrates these points and discuss our experience as a referral centre for CTEPH.