Omission of early oral anticoagulation after aortic bioprosthesis implantation was associated with a 1.75% risk of thromboembolic complications in the first six months following surgery.
Cohort (n=57)
Does omitting early oral anticoagulation increase the risk of thromboembolism in patients with an aortic bioprosthesis?
Omitting early oral anticoagulation after aortic bioprosthesis implantation is associated with a low risk of thromboembolism (1.75% at 6 months), suggesting standard anticoagulation may not be necessary given its bleeding risks.
Anticoagulation after implantation of a bioprosthetic heart valve has been suggested during a high-risk period of 3 months following surgery. There is little information available concerning the risk of thromboembolism during this period if anticoagulation is not carried out. However, this is of interest since 60-80% of all bleeding complications due to anticoagulation occur during the first year of treatment. Between 1983 and 1993, 57 of our patients did not receive oral anticoagulation after implantation of a bioprothesis in the aortic position (49 Hancock, 7 Mitroflow and one Edwards stentless). All patients were investigated retrospectively. A risk for thromboembolic complications of 1.75% is calculated for the first six months following surgery, being 3.5 per 100 patients/year. There seems to be no advantage in standard anticoagulation (INR 2.5-4) with its risk of serious bleeding complications of about 4% during this period of treatment. Low-dose anticoagulation (INR 2.0-2.3), however, preferably in combination with prothrombin estimation by the patients, seems to offer a relatively safe treatment for these patients.
Babin–Ebell et al. (Tue,) conducted a cohort in Aortic bioprosthesis implantation (n=57). No early oral anticoagulation was evaluated on Thromboembolic complications. Omission of early oral anticoagulation after aortic bioprosthesis implantation was associated with a 1.75% risk of thromboembolic complications in the first six months following surgery.