Non-cardiac surgery in patients with prosthetic heart valves: a 12 years experience.
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.
Akhtar
Raja Parvez
RP
Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore, Pakistan.
Abid
Abdul Rehman
AR
Zafar
Hasnain
H
Gardezi
Syed Javed Raza
SJ
Waheed
Abdul
A
Khan
Jawad Sajid
JS