Key result
Optimized oral anticoagulation with or without aspirin resolved all early nonobstructive prosthetic mitral valve thrombi, though large thrombi had a 43% thromboembolic event rate.
Why the study?
Does the combination of oral anticoagulants and aspirin improve thrombus resolution compared to oral anticoagulants alone in asymptomatic patients with early nonobstructive thrombosis of prosthetic mitral valves?
Population
20 asymptomatic patients with early nonobstructive thrombi revealed by systematic transesophageal…
Comparison
Combination of oral anticoagulants and aspirin vs Oral anticoagulants (fluindione) alone
Design
RCT, prospectively randomized into two groups
Follow-up
5 months
Authors
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Supports optimized anticoagulation for small early prosthetic mitral thrombi; leaves open aggressive strategies for large thrombi at high embolic risk.
RCT (n=20)
randomized
Does the combination of oral anticoagulants and aspirin improve thrombus resolution compared to oral anticoagulants alone in asymptomatic patients with early nonobstructive thrombosis of prosthetic mitral valves?
Optimized oral anticoagulation is effective for small (<5 mm) early postoperative nonobstructive prosthetic mitral valve thrombi, but large thrombi (≥5 mm) carry a high thromboembolic risk requiring more aggressive therapy.
Bémurat et al. (1999) conducted an RCT in Nonobstructive thrombosis of prosthetic mitral valve (n=20). Oral anticoagulants (fluindione) and aspirin vs. Oral anticoagulants (fluindione) alone was evaluated on Disappearance of prosthetic thrombi assessed by TEE at 5 months. Optimized oral anticoagulation with or without aspirin resolved all early nonobstructive prosthetic mitral valve thrombi, though large thrombi had a 43% thromboembolic event rate.
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