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[Valvular prosthesis and anticoagulant treatment]
Insights
Prosthetic valve replacement patients on anticoagulant therapy experienced few thromboembolic events. However, efficient anticoagulation in some patients still led to thrombosis, suggesting other risk factors may be involved.
Area of Science:
- Cardiovascular Surgery
- Hematology
Context:
- Prosthetic heart valve replacement is a common procedure.
- Long-term anticoagulation is standard for patients with prosthetic valves.
Purpose:
- To evaluate the incidence of thromboembolic accidents in patients with prosthetic heart valves.
- To investigate the role of anticoagulant therapy efficacy in preventing thromboembolic events.
Summary:
- A study followed 67 patients with prosthetic heart valves (53 mitral, 24 aortic, 10 tricuspid) for up to 9.5 years.
- Patients were grouped based on anticoagulant treatment adherence and efficacy.
- While patients with stopped or inefficient treatment had no thromboembolic events, three cases (two fatal) occurred in those with efficient treatment (prothrombin time ≤40%).
Impact:
- Anticoagulant therapy is crucial but may not be the sole determinant of thromboembolic events.
- Further research is needed to identify additional risk factors for thrombosis in prosthetic valve patients.
Abstract:
67 patients with prosthetic valvular replacement have been followed up for a period ranging from 6 months to 9 1/2 years; the overall number of valves was: 53 mitral, 24 aortic, 10 tricuspid valves. The average age of our patients was young (23.6 years). Many patients, because of their age or by lack of discipline or because of their social condition, had an inefficient anticoagulant treatment; they were subdivided into three groups. Those who stopped their anticoagulant treatment 6, those treatment was inefficient 25; in these two groups, no thrombo-embolic accident was noted, those whose treatment was efficient with a prothrombin time permanently lower than or equal to 40%: 36. It is in this very series that three cases of thrombosis occurred, two of which were lethal. Thus, although the indication for an anticoagulant treatment in patients with prosthetic valvar replacement remains indisputable, one may wonder, in front of such results, if there are not other factors, besides anticoagulant treatment, that result in thrombo-embolic accidents.