Antithrombotic management of patients with prosthetic heart valves: current evidence and future trends

Sun, Jack; Davidson, Michael J.; Lamy, André; Eikelboom, John W.

doi:10.1016/s0140-6736(09)60780-7

Cited by 205 publications

(152 citation statements)

References 99 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…This can be explained by the hypercoagulable state after surgery and the contact of bloodstream with the nonendothelialized thrombogenic surfaces particularly on suture sites and prosthesis material. 9 Bioprosthetic valves have a considerably less frequency of thrombosis, approximately 0.03% per year mainly seen in the first months following surgery while the sewing ring becomes endothelialized. 10,11 …”

Section: Prosthetic Valve Thrombosismentioning

confidence: 99%

Prosthetic heart valve obstruction: thrombolysis or surgical treatment?

Bonou

Λαμπρόπουλος

Barbetseas

2012

European Heart Journal: Acute Cardiovascular Care

View full text Add to dashboard Cite

Prosthetic valve thrombosis is a potentially life-threatening complication associated with high morbidity and mortality. Transthorasic and transoesophageal echocardiography play an important role to the diagnosis and provides incremental information about the optimal treatment strategy, while fluoroscopy and cardiac computed tomography may be of added value. Guidelines differ on whether surgical treatment or fibrinolysis should be the treatment of choice for the management of left-sided prosthetic valve thrombosis and these uncertainties underline the need for further prospective randomized controlled trials. Thrombus size, New York Heart Association functional class of the patient, the possible contraindications, the availability of each therapeutic option and the clinician's experience are important determinants for the management of prosthetic valve thrombosis.

show abstract

Section: Prosthetic Valve Thrombosismentioning

confidence: 99%

Prosthetic heart valve obstruction: thrombolysis or surgical treatment?

Bonou

Λαμπρόπουλος

Barbetseas

2012

European Heart Journal: Acute Cardiovascular Care

View full text Add to dashboard Cite

show abstract

“…The bridging regimen after heart surgery needing long term oral anticoagulation is still not clearly defined [7][8][9]. ESC guidelines [10] suggest that oral anticoagulation should be started during the first [11] indicates that bridging anticoagulation is typically started once postoperative bleeding is no longer an issue.…”

Section: Discussionmentioning

confidence: 99%

Bridging therapy to chronic anticoagulant treatment in patients undergoing cardiac surgery: comparison between low-molecular-weight heparin and subcutaneous unfractionated heparin. A pilot study

Rostagno¹,

Stefàno²

2017

Blood Heart Circ

View full text Add to dashboard Cite

show abstract

“…Prosthetic heart valves improve quality of life and survival of patients with severe valvular heart disease, but the need for antithrombotic therapy to prevent thrombotic complications in valve recipients poses challenges to clinicians and patients [1].…”

Section: Discussionmentioning

confidence: 99%

“…Rheumatic heart disease is a major burden in developing countries where it causes most of the cardiovascular morbidity and mortality in young people, leading to about 250,000 deaths per year [1]. Unfortunately there is not a perfect valve substitute.…”

Section: Introductionmentioning

confidence: 99%

Impact of aspirin use in the incidence of thromboembolic events after bioprosthesis replacement in patients with rheumatic disease

Durães¹,

Durães²,

Correia³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

View full text Add to dashboard Cite

Introduction: There is still much debate regarding the kind of antithrombotic therapy in the immediate postoperative period of bioprosthesis replacement (first three months). Thus, the authors consider relevant to determine the contemporary incidence of thromboembolic events in rheumatic patients early after implantation of aortic and mitral bioprosthesis replacement (first 90 days in the post-operative period) and perform a comparison between isolated Aspirin uses versus no-antiplatelet therapy, in this same context. Methods: Between the period of January 2010 to July 2012, all consecutive rheumatic patients, with basal sinus rhythm, who performed mitral and aortic valve replacement with bioprosthesis (pericardial bovine), were included in this prospective cohort study, 184 patients in total. The primary endpoint evaluated were the rate of embolic events.Results: In the first 30 days, there were three cerebral ischemic events among patients treated in Aspirin group (5.2%) compared with two events in patients without Aspirin therapy (1.7%), HR = 3.18; 95% CI 0.5 to 19.6; P=0.33. Between 31 and 90 days postoperatively, no patient had a primary outcome. The embolism-free survival, bleeding events and the overall survival were not statistically significant between the aspirin and no-antiplatelet groups.Conclusion: In conclusion, in this prospective cohort of rheumatic patients, we found a low and very rare incidence rate of embolic events during the first 90 days postoperative period in mitral and isolated aortic position, respectively. The use of aspirin did not significantly reduce the rate of thromboembolism. Descriptors 348Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Rev Bras Cir Cardiovasc 2013;28(3):347-52Durães AR, et al. -Impact of aspirin use in the incidence of thromboembolic events after bioprosthesis replacement in patients with rheumatic disease poor candidates to chronic use of vitamin K antagonist (VKA) [5,6], and were included in this prospective observational single-center cohort study.The main criteria used to classify a patient as a bad candidate to the use of VKA were the place of residence (rural or remote location of a hospital) and low socioeconomic level. The exclusion criteria were previous embolic events or atrial fibrillation, recent cerebral ischemia (6 months), coagulopathy, thrombophilia and allergies to ASA.Preoperative surgical risk was quantified with the European System for Cardiac Operative Risk Evaluation (EuroSCORE II) [7] and the Society of Thoracic Surgeons 2008 cardiac surgery risk model (the STS model) for isolated valve surgery [8].In this cohort, despite being an open study, the investigators did not have any influence on the postoperative administration of ASA. Of three surgical teams that performed the surgical procedures, only one recommended the routine use of ASA in this context, and the other two teams opted not to use it. The selection of the surgical team for each patient always followed a computerized electronic scheduling, and this system, through a ...

show abstract

Antithrombotic management of patients with prosthetic heart valves: current evidence and future trends

Cited by 205 publications

References 99 publications

Prosthetic heart valve obstruction: thrombolysis or surgical treatment?

Prosthetic heart valve obstruction: thrombolysis or surgical treatment?

Bridging therapy to chronic anticoagulant treatment in patients undergoing cardiac surgery: comparison between low-molecular-weight heparin and subcutaneous unfractionated heparin. A pilot study

Impact of aspirin use in the incidence of thromboembolic events after bioprosthesis replacement in patients with rheumatic disease

Contact Info

Product

Resources

About