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Related Experiment Videos

Anticoagulation in children with mechanical valve prostheses

S M Bradley1, R M Sade, F A Crawford

  • 1Division of Cardio horacic Surgery, Medical University of South Carolina, Charleston 29425-1095, USA.

The Annals of Thoracic Surgery
|July 1, 1997
PubMed
Summary

Warfarin sodium (Coumadin) and aspirin plus dipyridamole offer comparable protection against clotting complications in pediatric mechanical heart valve patients. Treatment choice may depend on individual patient factors.

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Area of Science:

  • Cardiovascular Medicine
  • Pediatric Cardiology
  • Pharmacology

Background:

  • Mechanical heart valves require anticoagulation to prevent clotting complications.
  • Warfarin sodium (Coumadin) and antiplatelet agents are used for prevention.
  • Efficacy and safety in pediatric patients remain unclear.

Purpose of the Study:

  • To compare the effectiveness and safety of warfarin sodium versus antiplatelet agents in children and young adults with mechanical heart valves.

Main Methods:

  • Prospective follow-up of 64 pediatric patients (≤18 years) with left-sided mechanical valves.
  • Comparison of 48 patients on Coumadin versus 16 on aspirin and dipyridamole.
  • Total follow-up of 272 patient-years on Coumadin and 116 patient-years on antiplatelets.

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Main Results:

  • No significant difference in survival or freedom from thromboembolism between groups.
  • Higher incidence of bleeding in the Coumadin group, but not statistically significant.
  • Literature review indicated similar thromboembolism and bleeding rates for both regimens.

Conclusions:

  • Coumadin and aspirin plus dipyridamole provide similar protection against complications in pediatric mechanical valve recipients.
  • Treatment selection may be influenced by patient preference and convenience.