Postoperative warfarin administration after valve replacement can lead to early cardiac tamponade if over-anticoagulation occurs, requiring careful monitoring.
Over-anticoagulation may precipitate early tamponade after valve replacement; case reports leave open optimal postoperative targets.
Two cases of cardiac tamponade associated with anticoagulant treatment in the early period after cardiac valve replacement are reported. The first case, a 48-year-old female with mitral valve re-stenosis underwent mitral valve replacement and received anticoagulant treatment with warfarin after surgery. Cardiac tamponade occurred on day 5 postoperatively when the thombotest value was 9%.The second case, a 49-year-old male with hypertension underwent aortic valve replacement and thoreafter received warfarin. Cardiac tamponade occurred on day 10 postoperatively when the thrombotest value was 13%. Both were treated successfully by surgical drainage.Postoperative anticoagulant treatment with warfarin appeared to the development of cardiac tamponade in both cases.
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Kudo et al. (1986) studied this question.
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