Comparison of the occurrence of thromboembolic and bleeding complications in patients with mechanical heart valve prosthesis with one and two leaflets in the mitral position

Abstract

IntroductionPatients with mechanical heart valve prostheses must continuously be treated with oral anticoagulants to prevent thromboembolic events related to prosthetesis. These patients should be continually evaluated for the control of oral anticoagulation.ObjectiveTo compare the occurrence of thromboembolic and hemorragic complications in patients with mechanical heart valve prosthesis with one (mono) and two (bi) leaflets in the mitral position in anticoagulant therapy.MethodsWe studied the 10-year interval, 117 patients with prosthesis in the mitral position, 48 with prosthetic single leaflet and 69 with two leaflets. We evaluated the occurrence of thromboembolic and hemorrhagic major and minor degree under gravity. The results are presented in an actuarial study and the frequency of occurrence of linear events.ResultsThe actuarial survival curves showed that over time, patients with prosthetic heart valve with one leaflet were less free of thromboembolic complications than patients with two leaflet prosthetic valve, while the latter (two leaflet) were less free of hemorrhagic accidents. The linearized frequency of occurrence of thromboembolism were higher in patients with mono leaflet prosthesis. Bleeding rates were higher for patients with bi leaflet prosthetic valve.ConclusionPatients with mono leaflet prosthetic heart valve showed that they are more prone to the occurrence of serious thromboembolic events compared to those with bi leaflet prosthetic valve. Patients with bi leaflet prosthetic valve had more bleeding than patients with mono leaflet prosthetic valve, however this difference was restricted to the bleeding of minor nature.

Self-care training and informational support of patients with a mechanical heart valve on the international normalized ratio and bleeding complications

“…In this study, based on the opinion of experts and previous studies [ 20 ] a checklist was designed to investigate the incidence of bleeding events, based on which bleeding events were divided into two categories: major hemorrhage complications included macroscopic hematuria, vaginal bleeding, hemoperitoneum, hemopericardium, severe gastrointestinal bleeding, hemorrhagic stroke, retroperitoneal hematoma; and minor hemorrhage complications included subcutaneous bleeding, epistaxis, microscopic hematuria, minor bleeding in stools, mild ocular bleeding, mild hemoptysis, gingival bleeding. To determine the validity of this checklist, the content validity method was used, and for this purpose the checklist was provided to 8 specialists (cardiologists, hematologists, and pharmacologists) and they were asked to express their views on the checklist items and, if there was a need to modify or edit, to comment.…”

Evaluation of hemostasis parameters after mitral valve replacement surgery with mechanical prostheses in patients with different treatment adherence

“…Маркова Маргарита Михайловна, аспирант кафедры внутренних болезней педиатрического факультета 1 . E-mail: kotlyarova_marga@mail.ru.…”

“…У же более чем пятидесятилетнюю историю насчитывает эволюция методов протезирования митрального клапана (МК) с разработкой и успешным внедрением в практику новых типов и конструкций протезов [1]. К настоящему времени широко используются биопротезы сердечных клапанов.…”

The Influence of Antithrombotic Drug Application on Intracranial Hemorrhage

“…Previous studies showed VKA increases the risk of intracranial hemorrhage (ICH) 1-6 fold, which induced the overwhelming majority (90%) of VKA related death [2][3][4]. With the increasing of INR, the risk of ICH will be increased even if INR is in the recommended range when VKA related ICH occurs in clinic mostly.…”