Document Detail

Anticoagulation protocol and early prosthetic valve thrombosis.
MedLine Citation:
PMID:  15584565     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: [corrected] Prosthetic valve thrombosis is a major cause of morbidity and mortality following heart valve replacement with a mechanical valve. METHODS AND RESULTS: 538 patients who underwent mechanical valve replacement between April 1999 and June 2003 were included in the study. They were divided into two groups. Group A (n=245) consisted of patients who underwent mechanical valve replacement between April 1999 and June 2001. Anticoagulation was started on the first post-operative day and consisted of only oral nicoumalone. Group B (n=293) consisted of patients who underwent mechanical valve replacement between July 2001 and June 2003; enoxaparin was started six hours following surgery in addition to oral nicoumalone which was started on first post-operative day. Fifteen (6.1%) patients in group A developed early prosthetic valve thrombosis at an interval of 4.33+/-0.97 months (range 3-6 months) following surgery. Ten had prosthetic valve thrombosis in the mitral position and five had prosthetic valve thrombosis in the aortic position. In group B, six (2.1%) patients developed early prosthetic valve thrombosis at a median interval of 4.58+/-0.9 months (range 3.5-6 months) in the mitral position (p=0.01). CONCLUSIONS: Addition of enoxaparin to the anticoagulation regime in the immediate post-operative period significantly reduces early prosthetic valve thrombosis.
Sachin Talwar; Chandra Kanta Kapoor; Devagourou Velayoudam; Arkalgud Sampath Kumar
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Indian heart journal     Volume:  56     ISSN:  0019-4832     ISO Abbreviation:  Indian Heart J     Publication Date:    2004 May-Jun
Date Detail:
Created Date:  2004-12-08     Completed Date:  2005-02-10     Revised Date:  2008-07-25    
Medline Journal Info:
Nlm Unique ID:  0374675     Medline TA:  Indian Heart J     Country:  India    
Other Details:
Languages:  eng     Pagination:  225-8     Citation Subset:  IM    
Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi.
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MeSH Terms
Anticoagulants / administration & dosage*,  therapeutic use
Enoxaparin / administration & dosage*,  therapeutic use
Follow-Up Studies
Heart Valve Prosthesis / adverse effects*
Medical Futility
Middle Aged
Postoperative Complications / etiology,  prevention & control
Thrombosis / etiology,  prevention & control*
Treatment Outcome
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin

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