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Revista chilena de cardiología

On-line version ISSN 0718-8560

Abstract

SEGUEL, Enrique et al. PREVENTION OF THROMBO-EMBOLIC EVENTS WITH ASPIRIN ALONE AFTER AORTIC VALVE REPLACEMENT WITH A BIOLOGIC PROSTHESIS. Rev Chil Cardiol [online]. 2013, vol.32, n.3, pp.196-203. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602013000300003.

Background: The abscense of a need for anticoagulant therapy is a significant advantage of biologic valve prosthesis. However, according to some clinical guidelines conventional anti-coagulant therapy is recommended for the initial 3 months following aortic valve replacement. Aim: The aim of this study was to evaluate morbi-mortality and thrombo-embolic events in patients undergoing aortic valve replacement with a bioprosthesis receiving aspirin during the first 3 months after surgery. Methods: Data on 229 patients (137 males), aged 65.3±11.8 years who received biologic aortic valve prosthesis between June 2006 and December 2011 was retrospectively analyzed. 51 patients underwent combined (coronary and/or mitral valve surgery) and 20 patients had infectious endocarditis. Morbidity, mortality, thrombo-embolic and hemorrhagic events were tabulated up to June 30, 2012. Results: During the first 30 days after surgery there were 4 cerebro-vascular events and 1 episode of mesenteric ischemia. Operative (30 day) mortality was 3.5% (8 patients). At 90 days, 2 patients had a hemorrhagic event (GI bleeding and hemotho-rax, respectively), but no further embolic events or deaths occurred. Patients were followed for a mean of 27.8 ±17,7 months (range 6 to 72 months). 17 patients died but no cases of embolism or bleeding were observed. Conclusion: Aspirin was safe and effective for prevention of thrombo-embolic complications following aortic valve replacement with a biologic prosthesis.

Keywords : aortic valve replacement; biologic valve prosthesis; anticoagulant treatment; aspirin.

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