Predictors of long term outcome in survivors of prosthetic valve thrombosis: role of medical treatment at discharge

Autor: G Teixido, Pilar Tornos, M.T. Gonzalez-Alujas, J.F. Rodriguez, David Garcia-Dorado, I. Buera, M. Mutuberria Urdaniz, J.G. Acosta, Artur Evangelista, Jordi Bañeras
Rok vydání: 2013
Předmět:
Zdroj: European Heart Journal. 34:P2129-P2129
ISSN: 1522-9645
0195-668X
Popis: Purpose: To assess the rate and predictors of adverse events during long-term follow-up of survivors of a prosthetic valve thrombosis (PVT) and the possible role of the treatment at discharge: oral anticoagulation (OAC) vs. dual therapy (DT: anticoagulation + antiplatelets). Methods: TTE, TEE and cine-radio-fluoroscopy were used for PVT diagnosis. According to guidelines, surgery was the treatment of choice in obstructive thrombosis and inoperable patients were treated with fibrinolysis or optimization of anticoagulation. Non-obstructives were first managed with optimization of anticoagulation. At discharge, survivors received OAC or DT, at the discretion of the attending physician. Adverse events were defined as cardiovascular death, recurrence, thromboembolic events or major bleeding. Results: From January 1984 to January 2013, 158 PVT were diagnosed in our institution, 108 obstructive, 50 non-obstructive (mean age 60 years;women 61%;mitral valve 83%). During hospitalization, surgery was performed in 64 patients (40,5%), fibrinolysis in 33 (21,0%) and optimization of anticoagulation in 61 (38,6%). Overall mortality was of 23% (26% with surgery,27% with fibrinolysis and 15% with anticoagulation). Thus, 121 patients survived and were included in the follow up study. At discharge, DT was prescribed in 68 patients: 83% of the fibrinolyzed patients (19/23), 65% of the anticoagulated (33/51) and 34% of the operated (16/47), (p
Databáze: OpenAIRE
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