The Beneficial Effect of Anticoagulation in Aortic Bioprosthesis is Associated with its Size

• Published in: Revista brasileira de cirurgia cardiovascular 2020-01, Vol.35 (3), p.307-313
• Main Authors: Dayan, Victor, Farachio, Paula, Arocena, Maria Jose, Fernandez, Amparo, Perez, Diego, Soca, Gerardo
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anticoagulants - therapeutic use; aortic valve; Aortic Valve - diagnostic imaging; Aortic Valve - surgery; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - drug therapy; Aortic Valve Stenosis - surgery; atrial fibrilation; bioprosthesis; Bioprosthesis - adverse effects; Blood clots; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiology; Ejection fraction; Heart surgery; Heart Valve Prosthesis - adverse effects; Heart Valve Prosthesis Implantation - adverse effects; Hemodynamics; hemorrhage; Hospitalization; Humans; ischemic attack; Medical imaging; Original; Prostheses; Prosthesis Design; stroke; SURGERY; Thrombosis; transient; Treatment Outcome
• ISSN: 1678-9741; 0102-7638; 1678-9741
• DOI: 10.21470/1678-9741-2019-0144

To evaluate the clinical and echocardiographic outcomes in aortic valve replacement (AVR) patients with aortic bioprosthesis under oral anticoagulation (OA). Patients who underwent AVR with bioprosthesiswere prospectively enrolled. They were classified based on postoperative use of OA. Clinical and operative variables were collected. Echocardiographic and clinical follow-ups were performed two years after surgery. The primary outcome evaluated was change in transprosthetic gradient. Secondary outcomes analyzed were change in New York Heart Association (NYHA) class, major bleeding episodes, hospitalization, stroke, and transient ischemic attack. We included 103 patients (61 without OA and 42 with OA). Clinical characteristics were similar among groups, except for younger age (76±6.3 vs. 72.4±8.1 years, P=0.016) and higher prevalence of atrial fibrillation (0% vs. 23.8%, P