CBS 2019
CBSMD教育中心
中 文

经导管主动脉瓣置换

Abstract

Recommended Article

von Willebrand Factor and Management of Heart Valve Disease: JACC Review Topic of the Week Cardiac surgery following transcatheter aortic valve replacement Impact of Incomplete Coronary Revascularization on Late Ischemic and Bleeding Events after Transcatheter Aortic Valve Replacement Impact of Pre-Existing and New-Onset Atrial Fibrillation on Outcomes After Transcatheter Aortic Valve Replacement Change in Kidney Function and 2-Year Mortality After Transcatheter Aortic Valve Replacement Coronary Access After TAVR With a Self-Expanding Bioprosthesis: Insights From Computed Tomography Coronary Protection to Prevent Coronary Obstruction During TAVR: A Multicenter International Registry Ambulatory Electrocardiogram Monitoring in Patients Undergoing Transcatheter Aortic Valve Replacement: JACC State-of-the-Art Review
|<<... 12 13 14 15 16 17 18 >>|

Original ResearchVolume 75, Issue 8, March 2020

JOURNAL：J Am Coll Cardiol. Article Link

Long-Term Outcomes of Anticoagulation for Bioprosthetic Valve Thrombosis

I Petrescu, AC Egbe, F Ionescu et al. Keywords: anticoagulation; bioprosthetic valve thrombosis; prosthetic valve failure

ABSTRACT

BACKGROUND - Early in the prevention and treatment of bioprosthetic valve thrombosis (BPVT), anticoagulation is effective, but the long-term outcome after BPVT is unknown.

 

OBJECTIVES - The goal of this study was to assess the long-term outcomes of patients with BPVT treated with anticoagulation.

 

METHODS - This analysis was a matched cohort study of patients treated with warfarin for suspected BPVT at the Mayo Clinic between 1999 and 2017.

 

RESULTS - A total of 83 patients treated with warfarin for suspected BPVT (age 57 ± 18 years; 45 men [54%]) were matched to 166 control subjects; matching was performed according to age, sex, year of implantation, and prosthesis type and position. Echocardiography normalized in 62 patients (75%) within 3 months (interquartile range [IQR]: 1.5 to 6 months) of anticoagulation; 21 patients (25%) did not respond to warfarin. Median follow-up after diagnosis was 34 months (IQR: 17 to 54 months). There was no difference in the primary composite endpoint between the patients with BPVT and the matched control subjects (log-rank test, p = 0.79), but the former did have a significantly higher rate of major bleeding (12% vs. 2%; p < 0.0001). BPVT recurred (re-BPVT) in 14 (23%) responders after a median of 23 months (IQR: 11 to 39 months); all but one re-BPVT patient responded to anticoagulant therapy. Patients with BPVT had a higher probability of valve re-replacement (68% vs. 24% at 10 years’ post-BPVT; log-rank test, p < 0.001).

 

CONCLUSIONS - BPVT was associated with re-BPVT and early prosthetic degeneration in a significant number of patients. Indefinite warfarin anticoagulation should be considered after a confirmed BPVT episode, but this strategy must be balanced against an increased risk of bleeding.

>CBS CBS 2019

> CBS 2019 REGISTRATION

> CBS 2019 PROGRAM

> CBS 2019 CALL FOR SCIENCE

> CBS 2019 SPOTLIGHTS

 CBSMD

> CBSMD WEBSITE REGISTRATION

> EDUCATION CENTER

> RECOMMANDED PAPER

> TOP 10 RESEARCH PAPER

> PRE-READING

CBS 2019 CBS 2019 FACULTY Education Resource CBSMD Scientific Library
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top