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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Is early antithrombotic therapy necessary after tissue mitral valve replacement?
Andrea Colli1, Roberto D'Amico, Carlos A Mestres
1Department of Cardiac Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. colli.andrea.bcn@gmail.com
The Journal of Heart Valve Disease
|September 18, 2010
Summary
Post-bioprosthetic mitral valve replacement (MVR), acetylsalicylic acid (ASA), vitamin K antagonists (VKA), or no antithrombotic therapy showed similar safety and efficacy. No specific therapy was superior in preventing valve thrombosis or thromboembolic events.
Area of Science:
- Cardiovascular Surgery
- Thrombosis Research
- Prosthetic Heart Valves
Background:
- Patients with prosthetic heart valves face increased risks of valve thrombosis and arterial thromboembolism.
- Optimal antithrombotic therapy post-bioprosthetic mitral valve replacement (MVR) remains debated.
Purpose of the Study:
- To evaluate the efficacy and safety of different postoperative antithrombotic strategies following bioprosthetic MVR.
- To compare acetylsalicylic acid (ASA), vitamin K antagonists (VKA), and no antithrombotic therapy (NT).
Main Methods:
- Retrospective analysis of 99 patients undergoing isolated bioprosthetic MVR between 2000-2006.
- Patients received ASA (100 mg/day), VKA (INR 2-3), or no specific antithrombotic therapy.
- Primary endpoints included cerebral ischemic events, bleeding events, and survival, with a mean follow-up of 23 months.
Main Results:
- Overall mortality was 13% (5% early, 8% late).
- Cerebral ischemic events occurred in 2.0% (ASA), 8.3% (VKA), and 8.3% (NT) (p=0.351).
- One major bleeding event (2.8%) occurred in the VKA group due to management issues.
Conclusions:
- All evaluated antithrombotic therapies (ASA, VKA, NT) demonstrated comparable safety profiles.
- No significant difference was observed in preventing valve thrombosis or thromboembolic events among the groups.
- Further research may be warranted to establish definitive optimal antithrombotic strategies.
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