AORTIC BIOPROSTHESIS WITHOUT EARLY ANTICOAGULATION - RISK OF THROMBOEMBOLISM

被引:24
作者
BABINEBELL, J
SCHMIDT, W
EIGEL, P
ELERT, O
机构
[1] Klinik/Poliklinik Herz/Thoraxchir., Universitat Wurzburg, D-97080 Wurzburg
关键词
HEART VALVE; ANTICOAGULATION; THROMBOEMBOLISM;
D O I
10.1055/s-2007-1013212
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Anticoagulation after implantation of a bioprosthetic heart valve has been suggested during a high-risk period of 3 months following surgery. There is little information available concerning the risk of thromboembolism during this period if anticoagulation is not carried out. However, this is of interest since 60-80 % of all bleeding complications due to anticoagulation occur during the first year of treatment. Between 1983 and 1993, 57 of our patients did not receive oral anticoagulation after implantation of a bioprothesis in the aortic position (49 Hancock, 7 Mitroflow and one Edwards stentless). AU patients were investigated retrospectively. A risk for thromboembolic compliations of 1.75 % is calculated for the first six months following surgery, being 3.5 per 100 patients/year. There seems to be no advantage in standard anticoagulation (INR 2.5-4) with its risk of serious bleeding complications of about 4 % during this period of treatment. Low-dose anticoagulation (INR 2.0-2.3), however, preferably in combination with prothrombin estimation by the patients, seems to offer a relatively safe treatment for these patients.
引用
收藏
页码:212 / 214
页数:3
相关论文
共 14 条
  • [1] BORTOLOTTI U, 1991, J CARDIAC SURG, V6, P544
  • [2] TRIAL OF COMBINED WARFARIN PLUS DIPYRIDAMOLE OR ASPIRIN THERAPY IN PROSTHETIC HEART-VALVE REPLACEMENT - DANGER OF ASPIRIN COMPARED WITH DIPYRIDAMOLE
    CHESEBRO, JH
    FUSTER, V
    ELVEBACK, LR
    MCGOON, DC
    PLUTH, JR
    PUGA, FJ
    WALLACE, RB
    DANIELSON, GK
    ORSZULAK, TA
    PIEHLER, JM
    SCHAFF, HV
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1983, 51 (09) : 1537 - 1541
  • [3] THROMBOTIC AND BLEEDING COMPLICATIONS OF PROSTHETIC HEART-VALVES
    EDMUNDS, LH
    [J]. ANNALS OF THORACIC SURGERY, 1987, 44 (04) : 430 - 445
  • [4] GARCIABENGOECHE.JB, 1991, EUR J CARDIO-THORAC, V5, P592
  • [5] GAUDEL G, 1979, SEM HOP PARIS, V55, P1340
  • [6] Gohlke-Barwolf C, 1993, J Heart Valve Dis, V2, P398
  • [7] HETZER R, 1982, 2ND P INT S CARD BIO, P170
  • [8] CLINICAL DURABILITY OF THE PERICARDIAL XENOGRAFT VALVE - 10 YEARS EXPERIENCE WITH MITRAL REPLACEMENT
    IONESCU, MI
    SMITH, DR
    HASAN, SS
    CHIDAMBARAM, M
    TANDON, AP
    [J]. ANNALS OF THORACIC SURGERY, 1982, 34 (03) : 265 - 277
  • [9] CARDIAC-VALVE REPLACEMENT IN THE ELDERLY - CLINICAL-PERFORMANCE OF BIOLOGICAL PROSTHESES
    JAMIESON, WRE
    BURR, LH
    MUNRO, AI
    MIYAGISHIMA, RT
    GEREIN, AN
    [J]. ANNALS OF THORACIC SURGERY, 1989, 48 (02) : 173 - 185
  • [10] MILANO AD, 1989, J THORAC CARDIOV SUR, V98, P37