Management of Intracranial Hemorrhage in the Setting of Mechanical Heart Valve Replacement Therapy

Abstract

The management of an intracranial hemorrhage in patients receiving anticoagulant therapy presents a significant challenge for medical professionals. Anticoagulant treatment is intended to prevent blood clotting, but it can worsen active brain bleeds. Despite this risk, avoiding the prothrombotic state caused by mechanical heart valves remains crucial. Guidelines on managing this issue are currently lacking, prompting a review that delves into embryonic development and anatomical functions of heart valves, valve replacement therapy for diseased valves, and the need for anticoagulants. Ultimately, recent literature and cases inform discussion regarding how best to manage intracranial hemorrhages in patients with mechanical heart valves. The expectation is that this examination will offer valuable perspectives on the handling of intracranial bleeding among individuals with mechanical heart valves and stimulate additional investigations in this intricate domain, particularly through the lens of applied mechanics.

The Management of Intracranial Aneurysms: Current Trends and Future Directions

“…Lower rates of epilepsy, infections, and pulmonary complications have been noted in patients > 65 years of age who underwent coiling when compared to clipping [ 82 ]. Also, the presence of comorbidities, poor clinical condition, and prior use of antiplatelets or anticoagulants favour endovascular treatment [ 83 ]. The aneurysm-related factors governing treatment modality are aneurysm size, neck size, morphology of aneurysm sac, relation to branch vessel, and location of the aneurysm.…”

Modeling Dynamics of the Cardiovascular System Using Fluid-Structure Interaction Methods

“…The utilization of computational techniques can be a viable and economical approach for assessing the flow parameters associated with heart valves. The inherent difficulties relating to long-term stability and biocompatibility in valve replacement or repair have underscored the necessity for more resilient methods that could address valvular disease effectively [72]. A thorough analysis of engineering practices and computational methodologies utilized in investigating the dynamic behavior of healthy and diseased heart valve closures is available in reference [73].…”

“…In the context of aneurysm repair, FSI holds particular significance as it can contribute to the selection of appropriate treatment strategies [72]. By integrating patient-specific geometries, material properties, and hemodynamic conditions, FSI models enable clinicians and researchers to assess the performance and efficacy of different interventions, such as stent graft placement and surgical techniques.…”