Hemodynamic changes during dental extraction and post-extraction bleeding in patients with prosthetic heart valves

Hemodynamic changes during dental extraction and postextraction bleeding were retrospectively evaluated in patients with prosthetic heart valves. It was found that the rate pressure product had a higher value in the period of anesthesia and during dental extraction. There was a tendency for a high RPP difference corresponding to an increased incidence of ECG changes, such as ST-T, QRS, P, and tachycardia. ECG changes were frequently observed high in procedures which required high doses of local anesthetic at one time or when multiple dental extractions were undertaken, whereas they seemed to have no positive relation to the number of heart valves replaced. Approximately 87% of the extractions were carried out under continuous anticoagulant therapy with a pretreatment coagulability level, of which 32% had bleeding during the first 24 h.