LESSON OF THE MONTH Management of intracranial bleeding associated with anticoagulation: balancing the risk of further bleeding against thromboembolism from prosthetic heart valves
نویسندگان
چکیده
Mechanical heart valves are associated with a risk of thromboembolism and anticoagulation is generally recommended. However, this is inevitably associated with a risk of intracranial bleeding. The case of a patient who sustained an intracranial bleed while taking warfarin for a prosthetic aortic valve and a further two intracranial bleeds while on heparin as an inpatient is discussed and the literature on the management of intracranial haemorrhage in patients on warfarin with prosthetic valves is reviewed. (J Neurol Neurosurg Psychiatry 2000;69:396–398)
منابع مشابه
Management of intracranial bleeding associated with anticoagulation: balancing the risk of further bleeding against thromboembolism from prosthetic heart valves.
Mechanical heart valves are associated with a risk of thromboembolism and anticoagulation is generally recommended. However, this is inevitably associated with a risk of intracranial bleeding. The case of a patient who sustained an intracranial bleed while taking warfarin for a prosthetic aortic valve and a further two intracranial bleeds while on heparin as an inpatient is discussed and the li...
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Thromboembolism, including systemic emboli and prosthetic valve thrombosis, is among the most dreaded complications after aortic valve replacement, with an annual incidence of major thromboembolism approaching 1.8 and 8 events per 100 patient-years on and off anticoagulation, respectively. Anticoagulation with warfarin is now routinely practiced with mechanical prosthetic heart valves to reduce...
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BACKGROUND The optimal intensity of oral anticoagulant therapy for patients with mechanical heart valves (i.e., the level at which thromboembolic complications are effectively prevented without excessive bleeding) is not known. We attempted to determine the optimal intensity by calculating the incidence of both complications at different levels of anticoagulation. METHODS Data were collected ...
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