Management of Therapeutic Anticoagulation in Perioperative Period and Post Cerebral Haemorrhage: Which the Best Strategies?

Abstract

Anticoagulation is essential for patients with mechanical heart valves; however, its management in peri operative period could be a dilemma. Frequently, bridging therapy is applied in this situation to prevent thromboembolic events. The risk and benefit of this strategy is not completely clarified. Furthermore, it become more complex if haemorrhagic complication was associated especially intracerebral localization. In lacking of data supporting a specific treatment strategy, The management of these patients often poses a significant challenge to balance between providing increasing bleeding events and providing ischemic complication. We report a case report of using bridging therapy in patient with mechanical valve in periprocedural cardiac resynchronization surgery complicated by hemorrhagic cerebral hematoma, through which we will discuss the therapeutic modalities of this patients in the light of studies and consensus of learned societies.