Antithrombotic therapy after bioprosthetic aortic valve replacement: ACTION Registry survey results.
OBJECTIVE
A variety of antithrombotic regimens have been described for the early postoperative period after bioprosthetic aortic valve replacement (AVR). This study reviews antithrombotic practice for patients undergoing bioprosthetic AVR with or without coronary artery bypass graft (CABG) amongst the centers participating in the ACTION (Anticoagulation Treatment Influence on Postoperative Patients) Registry.


RESULTS
An antithrombotic therapy questionnaire was answered by the 49 centers participating in the ACTION Registry located in Europe, Middle East, Canada and Asia. The 43% of centers prescribe vitamin K antagonist (VKA), 20% prescribe VKA and acetyl salicylic acid (ASA), 33% prescribe only ASA and 4% do not prescribe any therapy after bioprosthetic AVR. For patients undergoing bioprosthetic AVR and CABG 39% of the centers prescribe VKA and ASA, 37% prescribe VKA and 24% prescribe ASA. After the first three postoperative months following bioprosthetic AVR, 61% of the centers prescribe only ASA, while 39% do not prescribe any therapy. Patients with bioprosthetic AVR and CABG receive ASA in 90% centers, in 2% centers VKA and ASA, and 8% centers do not prescribe any antithrombotic.


CONCLUSIONS
This study demonstrates that, despite guidelines published by several professional societies, medical practice for the prevention of thrombotic events early after bioprosthetic AVR varies widely among cardiac surgical centers.
Colli
Andrea
A
Department of Cardiovascular Surgery, Hospital Clinic, Barcelona, Spain. colli.andrea@libero.it
Verhoye
Jean-Philippe
JP
Heijmen
Robin
R
Strauch
Justus Thomas
JT
Hyde
Jonathan A J
JA
Pagano
Domenico
D
Antunes
Manuel
M
Koertke
Heinrich
H
Ohri
Sunil Kumar
SK
Bail
Dorothee Helene Lina
DH
Leprince
Pascal
P
Van Straten
Bart H M
BH
Gherli
Tiziano
T
D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001705:Bioprosthesis; D002985:Clinical Protocols; D019538:Health Care Surveys; D006349:Heart Valve Diseases / Q000188:drug therapy / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D012042:Registries
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors