[Perioperative antocoagulation in patients with prosthetic heart valves: recommendations].
Lifelong anticoagulation, mainly with oral Vitamin K antagonists, represents the treatment of choice in patients with prosthetic heart valves to prevent thrombembolic complications. As a result, anticoagulant-related complications like excessive bleeding during interventions or surgical procedures will occur. Therefore, timely stopping of vitamin K antagonists prior to elective surgery is mandatory. However, based on the long half-life of all common vitamin K antagonists, interruption of oral anticoagulation will definitively lead to an increase of thrombembolic events. Hence, adequate bridging anticoagulation by temporary substitution of this therapy with heparin is necessary. This article gives a recommendation on the basis of the American College of Chest Physician and European Society of Cardiology current.
Wendt
D
D
Klinik für Thorax- und Kardiovaskuläre Chirurgie, Westdeutsches Herzzentrum, Universitätsklinikum Essen, Hufelandstraße 55, 45122 Essen, Deutschland. daniel.wendt@uk-essen.de
Piotrowski
J A
JA
Schönfelder
B
B
Marggraf
G
G
Thielmann
M
M
Jakob
H
H
D000925:Anticoagulants / Q000008:administration & dosage*; D006331:Heart Diseases / Q000209:etiology* / Q000517:prevention & control*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D019990:Perioperative Care; D011292:Premedication / Q000379:methods*; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control*
D000925:Anticoagulants
Eur Heart J. 2007 Jan;28(2):230-68
17259184
Thromb Res. 2008;123 Suppl 1:S58-61
18809206
Arch Surg. 2007 Feb;142(2):109-10
17309959
Chest. 1995 Dec;108(6):1683-9
7497782
Chest. 2008 Jun;133(6 Suppl):71S-109S
18574259
Eur Heart J. 2009 Oct;30(19):2369-413
19713420
Am J Cardiol. 2009 Nov 15;104(10):1429-33
19892063
Ann Surg. 2009 Aug;250(2):338-47
19638913