Experience with 813 aortic or mitral valve replacements with the Carpentier-Edwards bioprosthesis: Five year results

Soots, G; Pieronne, A; Roux, Jean-Pierre; Stankowiak, C; Warembourg, H; A, Watel; Prat, Alain; Segbeya, A.; Maatouk, M.; Crépin, F.

doi:10.1093/eurheartj/5.suppl_d.87

Cited by 11 publications

(4 citation statements)

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“…They concluded that early anticoagulation to maintain a prothrombin time between 1.5 and 2.0 (INR 3.0-4.5) should be administered for at least 3 months. This high level of anticoagulation might explain the higher rate of bleeding complications observed in these patients compared with previous reports [11,47,48]. They did not, however, distinguish between prostheses in the mitral and aortic positions.…”

Section: Literature Reviewcontrasting

confidence: 59%

Anticoagulation or antiplatelet therapy of bioprosthetic heart valves recipients: an unresolved issue

Colli

Verhoye

Leguerrier

et al. 2007

European Journal of Cardio-Thoracic Surgery

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Improvements in the performance and longevity of biological valve prostheses have steadily increased their rates of implantation in recent years. Aortic bioprostheses, which are commonly used in the elderly or when the risks of anticoagulating are high, have generally been associated with low rates of long-term complications. Freedom from anticoagulation, therefore, represents the main theoretical advantage of biological, compared with mechanical, aortic prostheses. While a variety of anticoagulant and antiplatelet drug regimens have been described, a precise antithrombotic protocol for the early postoperative period after bioprosthetic aortic valve replacement has not been developed. There are also important differences between the international guidelines published. This review examines the clinical evidence concerning the use of vitamin K antagonist and antiplatelet therapy in the early management of the antithrombotic complications after bioprosthetic aortic valve replacement.

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Section: Literature Reviewcontrasting

confidence: 59%

Anticoagulation or antiplatelet therapy of bioprosthetic heart valves recipients: an unresolved issue

Colli

Verhoye

Leguerrier

et al. 2007

European Journal of Cardio-Thoracic Surgery

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“…This high recommended level of anticoagulation therapy can explain the higher rate of bleeding in these patients compared with those previously reported. 25,34,35 Turpie et al 36 introduced a low-dose anticoagulation regimen in which the therapeutic target range was 2.0 to 2.3 INR, showing that serious bleeding complications seemed to be avoidable. In 1995 Orszulak et al 21 showed that early use of warfarin was beneficial only on a specific subset of patients who received BAVR.…”

Section: Discussionmentioning

confidence: 99%

Comparing warfarin with aspirin after biological aortic valve replacement: A prospective study

Gherli¹,

Colli²,

Fragnito³

2004

ACC Current Journal Review

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“…Third, are we sure that administering warfarin for the first 3 months after the operation (INR 2.5) allows time for endothelialization of the sewing ring, 34 suture knots, and valve leaflets?…”

Section: Discussionmentioning

confidence: 99%

Comparing Warfarin With Aspirin After Biological Aortic Valve Replacement

et al. 2004

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Background— Patients with prosthetic heart valves have a higher risk of developing valve thrombosis and arterial thromboembolism. Antithrombotic therapy in the early postoperative period after biological aortic valve replacement (BAVR) is controversial. The American College of Cardiology/American Heart Association and European Society of Cardiology guidelines recommend the use of warfarin for the first 3 months after BAVR, although the American College Chest Physician guidelines suggest that the recommendations are very weak and that the risk/benefit is unclear. This prospective study investigated the efficacy of postoperative warfarin compared with aspirin in patients after aortic valve replacement. Methods and Results— Patients undergoing BAVR between 2001 and 2002 received 2 antithrombotic therapies: 141 patients received warfarin for the first 3 months, and 108 patients received only aspirin. The major end points evaluated were the rate of cerebral ischemic events, bleeding, and survival. There were 3 and 5 postoperative cerebral ischemic events between 24 hours and 3 months for patients treated with aspirin and warfarin, respectively. After 3 months, the incidence of cerebral ischemic events did not differ between the 2 groups. The rate of major bleeding events, the stroke-free survival, and the overall survival rates were not statistically significant between the warfarin and aspirin groups. Conclusions— There seem to be no advantages in performing early anticoagulation therapy compared with a low-antiplatelet regimen with regard to early cerebral ischemic events, bleeding, and survival. Currently there is no evidence to support the fact that warfarin is more effective than aspirin.

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Experience with 813 aortic or mitral valve replacements with the Carpentier-Edwards bioprosthesis: Five year results

Cited by 11 publications

References 0 publications

Anticoagulation or antiplatelet therapy of bioprosthetic heart valves recipients: an unresolved issue

Anticoagulation or antiplatelet therapy of bioprosthetic heart valves recipients: an unresolved issue

Comparing warfarin with aspirin after biological aortic valve replacement: A prospective study

Comparing Warfarin With Aspirin After Biological Aortic Valve Replacement

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