Improving the quality of anticoagulant therapy in patients with mechanical heart valves: what are we waiting for?

Herijgers, Paul; Verhamme, Peter

doi:10.1093/eurheartj/ehm405

Cited by 15 publications

(12 citation statements)

References 15 publications

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“…Prosthetic heart valve thrombosis is a serious and urgent complication and related to the type and position of valve 1. Management of PVT remains controversial.…”

Section: Discussionmentioning

confidence: 99%

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Successful thrombolytic treatment of prosthetic mitral valve thrombosis

et al. 2013

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Prosthetic heart valve thrombosis is a rare but serious complication. Surgery is the first-line therapy in symptomatic obstructive mechanical valve thrombosis, thrombolytic therapy has been used as an alternative to surgical treatment. In this case report we described a 47-year-old woman who had undergone coronary artery bypass graft and mitral valve replacement operation 9 months ago. A thrombus was detected on the prosthetic mitral valve with high transmitral gradient by transoesophageal echocardiography. Tissue plasminogen activator treatment was administered successfully. The gradient was improved on prosthetic mitral valve and embolic complications or bleeding were not occurred.

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“…Prosthetic heart valve thrombosis is a serious and urgent complication and related to the type and position of valve 1. Management of PVT remains controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Prosthetic valve thrombosis (PVT) is one of the most important and a rare complication in patients with prosthetic heart valve 1. The diagnosis of PVT is made by clinical data and echocardiography.…”

Section: Introductionmentioning

confidence: 99%

Successful thrombolytic treatment of prosthetic mitral valve thrombosis

et al. 2013

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“…As for nonpregnant last-generation prosthetic heart valve patients, low-dose anticoagulation therapy has been well recognized as 1 of the possible means to improve quality of anticoagulant prophylaxis (7,8). However, because pregnancy prompts a hypercoagulable state, the feasibility of low-dose anticoagulation therapy in the peculiar setting of the heart valve prosthesis patient management during pregnancy is still undemonstrated.…”

Section: See Page 1116mentioning

confidence: 99%

Mechanical Aortic Valve Replacement in Young Women Planning on Pregnancy

Santo

Romano

Corte

et al. 2012

Journal of the American College of Cardiology

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In this small sample observational study, a pre-operative anticoagulation therapy trial helped young women scheduled for valve replacement to acquire complete information as to the choice of prosthetic device. In selected third-generation mechanical aortic prosthesis recipients, low-dose anticoagulation therapy seems safe and feasible for both mother and fetus. Further studies are needed to validate this approach.

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“…This might reverse the present trend to increased use of bioprosthetic valves 55. The step from preclinical in vitro and in vivo testing to widespread clinical use is hampered by the lack of good predictive animal models and always entails a certain risk.…”

Section: Prospective Indications For Dabigatran Etexilatementioning

confidence: 99%

New options with dabigatran etexilate in anticoagulant therapy

Maegdefessel¹

2010

VHRM

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Thrombosis, the localized clotting of blood, occurs in both the arterial and venous circulation, and has a major impact on health outcomes. The primary etiology of myocardial infarctions, and approximately 80% of strokes, is acute arterial thrombosis. In combination this represents the most common cause of death in the Western world, while the third leading cause of cardiovascular-associated death is venous thromboembolism. An understanding of the pathogenic changes in the vessel wall and the blood that result in thrombosis is crucial for developing safer and more effective antithrombotic drugs. Dabigatran etexilate belongs to a new class of direct thrombin inhibitors. Following oral administration, dabigatran reaches peak plasma concentrations within 2 hours, shows linear pharmacokinetics, and a limited (but important) amount of direct drug interactions. Given once daily at 150 mg or 220 mg, it has proven to be competitive with enoxaparin in the prevention of venous thromboembolism after major orthopedic surgery, with a comparable safety profile. For stroke prevention in patients suffering from atrial fibrillation, dabigatran administered at a dose of 110 mg twice daily was associated with rates of stroke and systemic embolism that were similar to those associated with warfarin, as well as lower rates of hemorrhage. Dabigatran given at a dose of 150 mg twice daily, as compared with warfarin, was associated with lower rates of stroke and systemic embolism but similar rates of major hemorrhage. Oral bioavailability of dabigatran, together with a rapid onset and offset of action and predictable anticoagulation response, makes this newly available antithrombotic drug an attractive alternative to traditional anticoagulant therapies for numerous thrombosis-related indications.

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Improving the quality of anticoagulant therapy in patients with mechanical heart valves: what are we waiting for?

Cited by 15 publications

References 15 publications

Successful thrombolytic treatment of prosthetic mitral valve thrombosis

Successful thrombolytic treatment of prosthetic mitral valve thrombosis

Mechanical Aortic Valve Replacement in Young Women Planning on Pregnancy

New options with dabigatran etexilate in anticoagulant therapy

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