Safety of temporary discontinuation of oral anti-coagulation in pattents with ST.Jude prosthetic valves

Goldenberg, Irvin F.; Gordon, Mark Forrest; Hunn, Donna; Pedersen, Wes R.; Roeller, Susanne K.; Madison, James D.; Mooney, M.; Gobel, Fredarick L.

doi:10.1016/0735-1097(90)92663-m

Cited by 2 publications

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“…They concluded that the discontinuation of oral anticoagulants 1 to 3 days prior to the day of surgery, allowing the prothrombin time to return to within 20% of the normal range, was not accompanied by an increased risk of thromboemboli in patients with prosthetic heart valves. Subsequently, Goldenberg et al [5] evaluated 160 patients with St. Jude mechanical bileaflet valves who had stopped their warfarin and found that only one patient experienced a thromboembolic event within 4 months. They concluded that temporary discontinuation of oral anticoagulation for an average of 5 days (range, 1-33 days) in patients with St. Jude mechanical prostheses did not appear to be accompanied by an increased risk of thromboembolic events.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, Goldenberg et al [5] reported that temporary discontinuation of oral anticoagulation in patients with St. Jude mechanical prostheses did not appear to be accompanied by an increased risk of thromboembolic events. We report a case of acute thrombus formation in the left atrium 3 days following the discontinuation of warfarin therapy prior to mitral valve replacement in a patient with mitral stenosis and atrial fibrillation.…”

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confidence: 96%

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Acute thrombus formation in the left atrium after the termination of warfarin

et al. 2004

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We report a case of acute thrombosis formation in the left atrium 3 days after the discontinuation of warfarin therapy prior to mitral valve replacement in a patient with mitral stenosis and atrial fibrillation. A 58-year-old Asian female patient was scheduled for mitral valve replacement for mitral stenosis. She had received warfarin therapy every day for 2 years. Warfarin therapy was discontinued 3 days before surgery. Using transesophageal echocardiography (TEE), we confirmed that there was no thromboembolism at the left atrium 10 days before surgery. No replacement anticoagulant therapy, such as heparin, was given after the discontinuation of warfarin. After the induction of anesthesia, a TEE probe was inserted through the esophagus to monitor left ventricular function. We found two thrombi (35 mm and 40 mm in diameter) in the left atrium. This case shows that discontinuation of warfarin therapy within a few days before operation carries a risk of thromboembolism formation.

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Section: Discussionmentioning

confidence: 98%

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confidence: 96%