Incidence of thromboembolic and bleeding complications after heart valves replacement
Dr. Zakir Hussain, Dr. Rakia Parveen, Dr. Nazar Hussain
Thromboembolic and bleeding complications is one of the most frequent complications of prosthetic heart valves and all the patients with these prosthesis need anticoagulation. Thromboembolism and bleeding are the consequences of inability to control the interaction between blood and synthetic material which was the major deterrent to earlier operations. The study was conducted retrospectively in the department of Surgery at District Hospital Rajouri, J&K, India, in collaboration with Department of CVTS SKIMS-Soura to correlate the type of valve and antithrombotic drug used to predict thromboembolic and bleeding complications and also to devise ways and means to prevent these complications. 9 volume of patients’ blood was collected in 1 volume of anticoagulant to find out the INR for anticoagulation titration. In total 466 patients were studied, 47.40% of the patients were in 31-40 years of age, 51.50% were male, 67.8% had undergone MVR.17.38% had undergone AVR and 14.8% had DVR done. Medtronic prosthesis was used in$1%, Bjork Shilly in27.5% of patients. Nicomalone (Acitrome) was the anticoagulant drug used in OPD. In addition 220 patients were on aspirin also. 38.10% of patients needed just 2 mgs daily dose of Nicoumalone and only 0.21% needed 7mg daily. Stroke was the commonest complication observed in patients. In patients with MVR complications was observed in 10 patients with INR in range of <1.5 to >2.5 and all the patients with AVR/DVR complications were observed with INR range of 2.0 to 2.5. In patients with MVR having TE complications 0.94% died, mortality was 2.89% in patients with DVR. In spite of all the precautions complications do occur. Anticoagulation after mechanical prosthesis is mandatory and Nicoumalone should be the drug of choice.
Dr. Zakir Hussain, Dr. Rakia Parveen, Dr. Nazar Hussain. Incidence of thromboembolic and bleeding complications after heart valves replacement. International Journal of Medical and Health Research, Volume 5, Issue 8, 2019, Pages 54-60