Thromboprophylaxis in congenital and acquired heart disease across the lifespan. A French consensus position statement: Part 2 – from adolescence to adulthood
Abstract
Patients with congenital and acquired heart disease are exposed to a lifelong thromboembolic risk that increases progressively from adolescence to adulthood because of residual lesions, arrhythmias, venous congestion, repeated interventions and acquired co-morbidities. Management is further complicated by concurrent bleeding risk. To provide practical expert consensus recommendations on thromboprophylaxis in congenital and acquired heart disease from adolescence to adulthood. A multidisciplinary expert panel from the Paediatric and Congenital Cardiology Branch of the French Society of Cardiology conducted a focused literature review and structured consensus process. Recommendations were graded pragmatically according to available evidence and expert agreement. Major clinical scenarios include Fontan circulation, Eisenmenger syndrome and Kawasaki coronary sequelae. From adolescence, bleeding risk may increase in girls and women as a result of dysovulation, menstruation and anticoagulant-related uterine bleeding, warranting gynaecological referral. In adulthood, thrombotic burden progressively increases through cumulative exposure to arrhythmias and reinterventions, such as transcatheter pulmonary valve replacement. Management should therefore rely on individualized treatment integrating thrombosis-bleeding balance, serial reassessment, patient education and tailored choice among antiplatelet therapy, vitamin K antagonists and direct oral anticoagulants. Thromboprophylaxis from adolescence to adulthood should move towards lifelong personalized care based on cumulative risk exposure, changing clinical status and sex-specific issues. Large prospective studies are required to refine risk stratification and optimize treatment pathways.
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BibTeX
@article{karsenty2026thromboprophylaxis,
title = {{Thromboprophylaxis in congenital and acquired heart disease across the lifespan. A French consensus position statement: Part 2 – from adolescence to adulthood}},
author = {Clement Karsenty and Magalie Ladouceur and Neil Derridj and Olivia Domanski and Estiballiz Valdeolmillos and Pamela Moceri and Dominique Lasne and Nicolas Combes and Ramona Ghenghea and Laurence Iserin and Francis Bessiere and Lea Linglart and Damien Bonnet and Sebastien Hascoet and Sophie Malekzadeh-Milani and Fanny Bajolle},
journal = {Archives of cardiovascular diseases},
year = {2026},
month = oct,
doi = {10.1016/j.acvd.2026.07.006},
url = {https://hal.science/hal-05785001v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Thromboprophylaxis in congenital and acquired heart disease across the lifespan. A French consensus position statement: Part 2 – from adolescence to adulthood
AU - Clement Karsenty
AU - Magalie Ladouceur
AU - Neil Derridj
AU - Olivia Domanski
AU - Estiballiz Valdeolmillos
AU - Pamela Moceri
AU - Dominique Lasne
AU - Nicolas Combes
AU - Ramona Ghenghea
AU - Laurence Iserin
AU - Francis Bessiere
AU - Lea Linglart
AU - Damien Bonnet
AU - Sebastien Hascoet
AU - Sophie Malekzadeh-Milani
AU - Fanny Bajolle
PY - 2026
DA - 2026/10/07
JO - Archives of cardiovascular diseases
DO - 10.1016/j.acvd.2026.07.006
UR - https://hal.science/hal-05785001v1
AB - Patients with congenital and acquired heart disease are exposed to a lifelong thromboembolic risk that increases progressively from adolescence to adulthood because of residual lesions, arrhythmias, venous congestion, repeated interventions and acquired co-morbidities. Management is further complicated by concurrent bleeding risk. To provide practical expert consensus recommendations on thromboprophylaxis in congenital and acquired heart disease from adolescence to adulthood. A multidisciplinary expert panel from the Paediatric and Congenital Cardiology Branch of the French Society of Cardiology conducted a focused literature review and structured consensus process. Recommendations were graded pragmatically according to available evidence and expert agreement. Major clinical scenarios include Fontan circulation, Eisenmenger syndrome and Kawasaki coronary sequelae. From adolescence, bleeding risk may increase in girls and women as a result of dysovulation, menstruation and anticoagulant-related uterine bleeding, warranting gynaecological referral. In adulthood, thrombotic burden progressively increases through cumulative exposure to arrhythmias and reinterventions, such as transcatheter pulmonary valve replacement. Management should therefore rely on individualized treatment integrating thrombosis-bleeding balance, serial reassessment, patient education and tailored choice among antiplatelet therapy, vitamin K antagonists and direct oral anticoagulants. Thromboprophylaxis from adolescence to adulthood should move towards lifelong personalized care based on cumulative risk exposure, changing clinical status and sex-specific issues. Large prospective studies are required to refine risk stratification and optimize treatment pathways.
SN - 1875-2136
SN - 1875-2128
ER -