title: Non-cardiac surgery in patients with prosthetic heart valves: a 12 years experience.
abstract: OBJECTIVE
  To study patients with mechanical heart valves undergoing non-cardiac surgery and their anticoagulation management during these procedures.
  
  
  METHODS
  It was a cohort study.
  
  
  METHODS
  The study was conducted at the Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore and Department of Surgery, Services Institute of Medical Sciences, Lahore, from September 1994 to June 2006.
  
  
  METHODS
  Patients with mechanical heart valves undergoing non-cardiac surgical operation during this period, were included. Their anticoagulation was monitored and anticoagulation related complications were recorded.
  
  
  RESULTS
  In this study, 507 consecutive patients with a mechanical heart valve replacement were followed-up. Forty two (8.28%) patients underwent non-cardiac surgical operations of which 24 (57.1%) were for abdominal and non-abdominal surgeries, 5 (20.8%) were emergency and 19 (79.2%) were planned. There were 18 (42.9%) caesarean sections for pregnancies. Among the 24 procedures, there were 7(29.1%) laparotomies, 7(29.1%) hernia repairs, 2 (8.3%) cholecystectomies, 2 (8.3%) hysterectomies, 1(4.1%) craniotomy, 1(4.1%) spinal surgery for neuroblastoma, 1(4.1%) ankle fracture and 1(4.1%) carbuncle. No untoward valve or anticoagulation related complication was seen during this period.
  
  
  CONCLUSIONS
  Patients with mechanical valve prosthesis on life-long anticoagulation, if managed properly, can undergo any type of non-cardiac surgical operation with minimal risk.
authors.affiliation: Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore, Pakistan.
authors.forename: Raja Parvez
authors.initials: RP
authors.lastname: Akhtar
authors.forename: Abdul Rehman
authors.initials: AR
authors.lastname: Abid
authors.forename: Hasnain
authors.initials: H
authors.lastname: Zafar
authors.forename: Syed Javed Raza
authors.initials: SJ
authors.lastname: Gardezi
authors.forename: Abdul
authors.initials: A
authors.lastname: Waheed
authors.forename: Jawad Sajid
authors.initials: JS
authors.lastname: Khan