Archive for the 'Antithrombotic Therapy' Category

22 Oct

Antithrombotic Therapy in Mechanical and Biological Prosthetic Heart Valves and Saphenous Vein Bypass Grafts: Saphenous Vein Bypass Grafts

Warfarin was reported by some to be of no advantage at 6 months or at 1-2 years, but a larger group of patients at 2 months showed a significant difference (90% graft patency vs 85% graft patency) (p<.015) (Table 8). Regarding the use of anticoagulants or antiplatelet agents in patients with internal mammary artery bypass […]

21 Oct

Antithrombotic Therapy in Mechanical and Biological Prosthetic Heart Valves and Saphenous Vein Bypass Grafts: Additional information

Additional information regarding the effect of antiplatelet therapy on graft patency has been derived from the VA Cooperative Study. Postoperative angiograms were obtained within 60 days of surgery (level I study).49A The drug regimens employed included: (1) aspirin 325 mg/day; (2) aspirin 975 mg/day; (3) aspirin 975 mg/day combined with dipyridamole 225 mg/day; and (4) […]

20 Oct

Antithrombotic Therapy in Mechanical and Biological Prosthetic Heart Valves and Saphenous Vein Bypass Grafts: Saphenous Vein Bypass Grafts

Aspirin in various doses has been evaluated in patients with bioprosthetic valves in nonrandomized (level III and IV) studies. Among patients in normal sinus rhythm, even though the risk of thromboembolism is low, aspirin may offer additional protection against thromboemboli. Even among patients with AF, the frequency of thromboemboli with aspirin alone was very low […]

19 Oct

Antithrombotic Therapy in Mechanical and Biological Prosthetic Heart Valves and Saphenous Vein Bypass Grafts: Valves in the mitral position

Thromboemboli occurred more frequently in patients with valves in the mitral position than in those with valves in the aortic position, and more often in patients with multiple bioprosthetic valves than in those with a single bioprosthetic valve. The higher incidence of emboli from the mitral valve, however, may reflect the more frequent occurrence of […]

18 Oct

Antithrombotic Therapy in Mechanical and Biological Prosthetic Heart Valves and Saphenous Vein Bypass Grafts: Bioprosthetic Valves

Regarding the use of antiplatelet agents alone, in patients with a St. Jude valve, a few studies are completed, and the results are inconsistent (Table 4A). Some showed an incidence of thromboembolic events with antiplatelet agents between 2.1/100 patients/year and 3.2 patients/year, and these values were not different from some reports with anticoagulant ther-apy.37A37B On […]

17 Oct

Antithrombotic Therapy in Mechanical and Biological Prosthetic Heart Valves and Saphenous Vein Bypass Grafts: Occurrence of thromboemboli

The occurrence of thromboemboli in patients with Medronic-Hall valves parallels the experience with other disc-occluder valves. Among 379 patients in whom the PT was maintained at 2-2.5 times control (presumably using North American thromboplastin), thromboembolic events occurred at a rate of 2.3/100 patient years after mitral valve replacement and at 2.1/100 patient years after aortic […]

16 Oct

Antithrombotic Therapy in Mechanical and Biological Prosthetic Heart Valves and Saphenous Vein Bypass Grafts: Thromboemboli

Only rarely have reports been published of patients with ball valves who were untreated with either anticoagulants or antiplatelet agents (Table 1). With cloth-covered Starr-Edwards aortic valves, a nonrandomized comparative (level III) study of patients who either never received anticoagulants or in whom anticoagulants were discontinued after 1 year showed acceptable rates of thromboembolism compared […]

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