Journal Article

Early antithrombotic management after valve replacement

M. Dahm, G. Hafner, H. Schinzel, E. Mayer, D. Prüfer and H. Oelert

in European Heart Journal Supplements

Published on behalf of European Society of Cardiology

Volume 3, issue suppl_Q, pages Q12-Q15
Published in print December 2001 | ISSN: 1520-765X
Published online December 2001 | e-ISSN: 1554-2815 | DOI: http://dx.doi.org/10.1016/S1520-765X(01)90036-7
Early antithrombotic management after valve replacement

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Because of the substantial risk of thromboembolism early after valve replacement, perioperative initiation of anticoagulation is necessary, despite the increased risk for bleeding. Anticoagulation should be initiated within 24 h after the procedure with unfractionated heparin or low-molecular-weight heparin (LMWH). Subcutaneous LMWH appears more beneficial than intravenous heparin therapy, but this approach requires further evaluation. Oral anticoagulants, preferably at low dosage, are added following the removal of chest tubes. Heparin anticoagulation is monitored by checking the activated partial thromboplastin time or anti-Xa activity, and the International Normalized Ratio (INR) is used to measure the effects of oral anticoagulants. Heparin treatment should be continued until the INR is stable in the therapeutic range in order to avoid hypercoagulable conditions caused by varying degrees of decay in coagulation factors.

Keywords: Early antithrombotic management; heart valve replacement; monitoring of oral anticoagulation

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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