Why the study?
Prosthetic valve thrombogenicity and bleeding complications from lifelong anticoagulation pose morbidity and mortality risks, especially during other surgical interventions, with few clinical trials addressing management.
How should anticoagulation be managed in patients with prosthetic heart valves undergoing non-cardiac operations?
How should anticoagulation be managed in patients with prosthetic heart valves undergoing non-cardiac operations?
This paper proposes guidelines for managing the delicate balance of anticoagulation in patients with prosthetic heart valves who require non-cardiac surgery.
Risk-adjusted anticoagulation guidelines merit adoption for prosthetic valve patients undergoing non-cardiac surgery; extends prior recommendations with individualized risk stratification.
Prosthetic valve thrombogenicity and bleeding complications associated with life-long anticoagulation are constant potential causes of morbidity and mortality following prosthetic valve implantation. The conflict between over- and under-anticoagulation is even more of a problem when other surgical interventions are required. Very few clinical trials have addressed this issue. We propose some guidelines based on the concept of risk-adjusted intensity of anticoagulation but stress the need for caution with interpretation of these recommendations.
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Busuttil et al. (1995) conducted a review in Prosthetic heart valves undergoing non-cardiac operations. Risk-adjusted intensity of anticoagulation was evaluated. Guidelines based on risk-adjusted intensity of anticoagulation were proposed for managing patients with prosthetic heart valves undergoing non-cardiac operations.
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