Major Hemorrhagic and Thromboembolic Complications in Patients with Mechanical Heart Valves Receiving Oral Anticoagulant Therapy

Trzeciak, Przemysław; Zembala, Marian; Poloński, Lech

doi:10.1532/hsf98.20091097

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…38,39 Anticoagulation management in these patients is challenging due to narrow therapeutic windows and the need to balance bleeding versus adequate coagulation, influenced by numerous food and drug interactions and interindividual variability in dose response. [40][41][42] Therefore, with some anticoagulants, patients require frequent laboratory testing of coagulation status, imposing a staggering load on primary care services. [43][44][45][46] Vitamin K antagonists (VKAs) were the only oral anticoagulants available to patients for decades.…”

Section: Hemostatic Profiling In Anticoagulated Patients Using Lsrmentioning

confidence: 99%

Comprehensive Coagulation Profiling at the Point-of-Care Using a Novel Laser-Based Approach

Nadkarni

2019

Semin Thromb Hemost

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Delays in identifying internal bleeding are life-threatening, thus underscoring the need for rapid and comprehensive coagulation profiling at the bedside. The authors review a novel optical coagulation profiler that measures several coagulation metrics including prothrombin time, activated clotting time, clot polymerization rate (α-angle), clot stiffness (maximum amplitude), fibrinolysis (LY), and platelet function, using a single multifunctional instrument. The optical profiler is based on the principles of Laser Speckle Rheology that quantifies tissue viscoelasticity from light scattering patterns called laser speckle. To operate the optical profiler, whole blood (40 μL) is loaded into a disposable cartridge, laser speckle patterns are recorded via a camera, and the viscoelasticity of clotting blood is estimated from speckle intensity fluctuations. By monitoring alterations in viscoelastic moduli over time during clot initiation, thrombin generation, fibrin crosslinking, clot stabilization, and LY, global coagulation parameters are obtained within 10 minutes using a drop of whole blood. Clinical testing in over 500 patients to date has confirmed the accuracy of the optical profiler for comprehensively assessing coagulation status against conventional coagulation tests and thromboelastography. Recent studies have further demonstrated the capability to quantify platelet aggregation induced by adenosine diphosphate in a drop of platelet-rich-plasma in the absence of applied shear stress. Together, these studies demonstrate that global coagulation profiling in addition to platelet function may be accomplished using a single multifunctional device. Thus, by enabling rapid and comprehensive coagulation and platelet function profiling at the bedside, the optical profiler will likely advance the capability to identify and manage patients with an elevated risk for hemorrhage.

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Section: Hemostatic Profiling In Anticoagulated Patients Using Lsrmentioning

confidence: 99%

Comprehensive Coagulation Profiling at the Point-of-Care Using a Novel Laser-Based Approach

Nadkarni

2019

Semin Thromb Hemost

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“…The problem of prosthesis choice has always been topical. Mechanical prostheses are durable, but there are high risks of thromboembolic complications, so lifelong anticoagulant therapy is required [5]. Biological prostheses form a flow structure close to the physiological one, and the gradual development of dysfunction makes it possible to perform repeated surgery as planned [6].…”

Section: Introductionmentioning

confidence: 99%

“…(5,6) Previous surgeries on the aortic valve, n (%)8 (4)Infectious endocarditis, n(%) 5(2,5) Bicuspid aortic valve, n(%) 30(15,2) Degenerative aortic valve, t(%)…”

mentioning

confidence: 99%

Immediate and Medium-Term Results of Aortic Valve Replacement With Biological Prosthesis in Elderly Patients: One Center’s Experience

Kadyraliev,

Belov,

Marchenko

et al. 2023

Preprint

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Currently, aortic valve (AV) disease is the most common reason for heart valve surgery. The gold standard of care for people with aortic pathology is thought to be AV replacement. The issue of prosthesis selection has always been important. Although mechanical prosthesis are robust, lifelong anticoagulation medication is necessary due to the significant risk of thromboembolic consequences. Biological prostheses have a flow structure that is similar to the physiological one, and as malfunction gradually sets in, scheduled recurrent surgery can be carried out. The purpose of this study is to evaluate the short- and long-term effects of biological prosthetic aortic valve replacement (AVR) in elderly individuals. The study included 198 patients with AV pathology [85 men (42.9%)/113 women (57.1%)]. The median age was 70 [66–73] years. There were 175 (88.4%) patients with degenerative AV, 5 (2.5%) with infective endocarditis, and 30 patients (15.2%) had bicuspid AV. The median follow-up period was 26.3±1.4 months. Hospital mortality was 4.5%. No wound complications were detected. Thirty-one patients died in the long-term period. The causes of lethality were: cardiovascular disease (13 patients), malignant neoplasm (5 patients), gastrointestinal disease (2 patients), urinary system disease (1 patient), COVID-19 (1 patient), unknown cause (9 patients). Thus, the five-year postoperative survival rate was 63%, respectively. Throughout the observation period, two patients (2.9%) underwent reoperation on AV. 97.1% of patients were free of reoperation after five years. The five-year survival rate was 63% due to the history of severe concomitant pathology and mean age of the patients of 70 years.

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Restarting Oral Anticoagulant in Patients with Mechanical Heart Valve(s) and Intracranial Haemorrhage

Alkherayf¹

2012

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Major Hemorrhagic and Thromboembolic Complications in Patients with Mechanical Heart Valves Receiving Oral Anticoagulant Therapy

Cited by 3 publications

References 25 publications

Comprehensive Coagulation Profiling at the Point-of-Care Using a Novel Laser-Based Approach

Comprehensive Coagulation Profiling at the Point-of-Care Using a Novel Laser-Based Approach

Immediate and Medium-Term Results of Aortic Valve Replacement With Biological Prosthesis in Elderly Patients: One Center’s Experience

Restarting Oral Anticoagulant in Patients with Mechanical Heart Valve(s) and Intracranial Haemorrhage

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