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Anticoagulation After Biological Aortic Valve Replacement: Is There An Optimal Regimen?
Owais, Tamer; Rouman, Mina; Breuer, Martin; Hüter, Lars; Fuchs, Jürgen; Lauer, Bernward; Kuntze, Thomas.
Afiliación
  • Owais T; Department of Cardiac Surgery and Cardiology, Central Clinic of Bad Berka, Germany.
  • Rouman M; Department of Cardiac Surgery and Cardiology, Central Clinic of Bad Berka, Germany.
  • Breuer M; Department of Cardiac Surgery and Cardiology, Central Clinic of Bad Berka, Germany.
  • Hüter L; Department Anaesthesiology and Intensive Medicine, Central Clinic of Bad Berka, Germany.
  • Fuchs J; Department Anaesthesiology and Intensive Medicine, Central Clinic of Bad Berka, Germany.
  • Lauer B; Department of Cardiac Surgery and Cardiology, Central Clinic of Bad Berka, Germany.
  • Kuntze T; Department of Cardiac Surgery and Cardiology, Central Clinic of Bad Berka, Germany.
J Heart Valve Dis ; 25(2): 139-144, 2016 03.
Article en En | MEDLINE | ID: mdl-27989055
BACKGROUND: The anticoagulation of biological heart valves remains a 'hot spot' of discussion in various domains due to the risk of developing valve thrombosis and arterial thromboembolism. The situation has always been controversial, especially during the early postoperative phase. The American College of Cardiology/ American Heart Association and European Society of Cardiology guidelines recommend the use of warfarin for the first three months after biological aortic valve replacement (BAVR), although the American College of Chest Physicians guidelines suggest that these recommendations are experience-based and that the risk/benefit is unclear. The aim of the present study was to compare the efficacy of aspirin and warfarin in patients after BAVR. METHODS: A total of 863 patients who underwent BAVR between 2008 and 2015 was allocated to two groups. Each group was managed with a specific anticoagulation regimen, with 430 patients receiving warfarin during the first three postoperative months, and 433 receiving aspirin. The major study end points were bleeding, cerebral ischemic events, and survival. RESULTS: In total, 10 and 15 postoperative cerebral ischemic events occurred between 24 h and three months after surgery in patients treated with aspirin and warfarin, respectively. After three months the incidence of cerebral ischemic events did not differ greatly between the two groups. The rate of major bleeding events and rates of stroke-free survival and overall survival were not statistically significant between the warfarin and aspirin groups. CONCLUSIONS: Plasma anticoagulation with warfarin during the early postoperative phase was shown statistically to be inferior to platelet aggregation inhibition by aspirin with regards to postoperative bleeding risk, cerebral ischemic events, and survival.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Warfarina / Bioprótesis / Coagulación Sanguínea / Prótesis Valvulares Cardíacas / Inhibidores de Agregación Plaquetaria / Aspirina / Implantación de Prótesis de Válvulas Cardíacas / Enfermedades de las Válvulas Cardíacas / Anticoagulantes Tipo de estudio: Etiology_studies / Observational_studies / Qualitative_research / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: J Heart Valve Dis Asunto de la revista: CARDIOLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido
Buscar en Google
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Imprimir
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Warfarina / Bioprótesis / Coagulación Sanguínea / Prótesis Valvulares Cardíacas / Inhibidores de Agregación Plaquetaria / Aspirina / Implantación de Prótesis de Válvulas Cardíacas / Enfermedades de las Válvulas Cardíacas / Anticoagulantes Tipo de estudio: Etiology_studies / Observational_studies / Qualitative_research / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: J Heart Valve Dis Asunto de la revista: CARDIOLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido