Perioperative heparin based anticoagulation for patients with a history of cardiac valve replacement
10.3760/cma.j.issn.1007-631X.2009.11.009
- VernacularTitle:人工心脏瓣膜置换术后再行腹部手术围术期抗凝安全性的探讨
- Author:
Shuqi ZHANG
;
Jiexiong LIANG
;
Jixiang WU
- Publication Type:Journal Article
- Keywords:
Heparin,low-molecular-weight;
Heart valve prosthesis;
Warfarin
- From:
Chinese Journal of General Surgery
2009;24(11):889-891
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the safety and effectiveness of using low molecular weight heparin (LMWH) in place of warfarin for anticoagulation in patients with a previous cardiac valve replacement. Methods We reviewed 70 patients hospitalized from Jan 2002 to Apr 2009 undergoing abdominal surgery who have had a previous cardiac valve replacement and had been on warfarin anticoagulation therapy. LMWH began to replace warfarin for anticoagulation 3 clay before the surgery in 33 cases, while the other 37 patients simply ceased to use any anticoagulant since 3 days before the surgery. Postoperative bleeding and embolism risk were compared between these two groups. Results There were 2 patients suffering from postoperative bleeding in the operative field in LMWH group, while there was no postoperative bleeding in patients on anticoagulant suspension group (χ~2=0.641, P>0.05). There was no valve embolism occurred in these two groups. Conclusions It is a safe way to stop using warfarin with LMWH taking the task for perioperative anticoagulation in patients with a history of cardiac valve replacement 3 days before an elective abdominal surgery. This protocol decreases the risk rate of valve embolism not at the expense of increasing postoperative bleeding.
