[Anticoagulation in patients with cardiac valve prostheses].
Patients with heart valve prostheses carry a higher risk of thromboembolic events compared to the normal population. In many cases anticoagulation is required after heart valve replacement. Thromboembolic risk is related to valve prosthesis design, patient own characteristics and adequacy of anticoagulation. Recent advance in the understanding of the pathophysiology of thrombus formation and pharmacological characteristics of most used anticoagulants are discussed. Suggestions for anticoagulation regimen are given according to recent randomised clinical trials based on prosthesis type, site of implant and patients clinical characteristics. Emphasis is given for cumbersome situations such as pregnancy and major hemorrhage in which anticoagulation has to be interrupted.
Paparella
Domenico
D
Istituto di Cardiochirurgia, Dipartimento d'Emergenza e Trapianti d'Organo, Università, Bari. paparella@tin.it
d'Agostino
Chiara
C
Schinosa
Luigi de Luca Tupputi
Lde L
D000925:Anticoagulants / Q000627:therapeutic use*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D006493:Heparin