According to current guidelines, in patients without additional risk factors who have undergone aortic valve replacement with a bioprosthesis, anticoagulation in the first 3 months after surgery is still a matter of debate. According to current evidence, aspirin in low doses is a reasonable alternative to vitamin K antagonists (VKA). A comparison is made between the incidence of thrombotic and haemorrhagic complications in patients with low thrombotic risk who underwent aortic valve replacement with a bioprosthesis in the National Institute of Cardiology of Ignacio Chávez of Mexico. The hypothesis: aspirin as monotherapy has a beneficial effect compared to VKA. The studied patients were the low thrombotic risk patients who underwent aortic valve replacement with a bioprosthesis in the National Institute of Cardiology of Ignacio Chávez of Mexico from 2011 to 2015. The groups studied were: aspirin only, VKA only, and the combination of VKA plus aspirin. The patients were retrospectively followed-up for 12 months, and the thrombotic and haemorrhagic complications were documented. Of the 231 patients included in the study, only one patient in the VKA only group presented with a haemorrhagic complication. No thrombotic complications were observed. In the present study no thrombotic complications were observed in patients who did not receive anticoagulation in the first 3 months after an aortic valve replacement with a bioprosthesis after a follow up period of 12 months. This suggests that the use of aspirin only is safe during this period.
In cardiac medicine, Dr. Michael Ellis DeBakey is the undisputed pioneer of this century, maybe even in history. The design of the ventricular assist device (VAD), the Dacron-created artificial blood vessel and his many other firsts revolutionized heart surgery (specifically aortic surgery) forever. In fact, his contributions were enormous and left and amazing legacy. DeBakey was known to have a temper and that he was a very difficult surgeon to work with. However, even his critics could not deny the impact he had on the world of medicine. In his early nineties, he still practiced surgery. DeBakey was a man that accomplished all he set out to do and died on early July 2008.
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