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Anticoagulation protocol and early prosthetic valve thrombosis
Sachin Talwar1, Chandra Kanta Kapoor, Devagourou Velayoudam
1Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi.
Indian Heart Journal
|December 9, 2004
Summary
Early prosthetic valve thrombosis is a serious risk after mechanical heart valve replacement. Adding enoxaparin to the standard anticoagulation regimen significantly reduces this risk.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Medical Devices
Background:
- Prosthetic valve thrombosis (PVT) is a significant complication following mechanical heart valve replacement.
- PVT contributes substantially to patient morbidity and mortality.
Purpose of the Study:
- To evaluate the efficacy of adding enoxaparin to oral anticoagulation in reducing early prosthetic valve thrombosis.
Main Methods:
- A retrospective study of 538 patients undergoing mechanical valve replacement.
- Group A (n=245) received oral nicoumalone from postoperative day 1.
- Group B (n=293) received enoxaparin from 6 hours post-surgery plus oral nicoumalone from postoperative day 1.
Main Results:
- Group A had 15 cases (6.1%) of early PVT.
- Group B had 6 cases (2.1%) of early PVT (p=0.01).
- PVT occurred in mitral and aortic positions.
Conclusions:
- Immediate postoperative enoxaparin administration significantly decreases early prosthetic valve thrombosis.
- This anticoagulation strategy improves outcomes after mechanical heart valve replacement.