Postoperative Anticoagulation in Patients with Mechanical Heart Valves Following Surgical Treatment of Subdural Hematomas

Neurocritical Care , 04/16/2012

Amin AG et al. – Interruptions in anticoagulation therapy for up to 3 weeks pose minimal thromboembolic risk in patients with mechanical heart valves. Close follow–up after discharge is highly recommended, as recurrent hemorrhages can occur several weeks after the resumption of anticoagulation.


  • Outcomes were retrospectively reviewed for 12 patients on anticoagulation therapy for thromboembolic prophylaxis for mechanical cardiac valves who underwent surgical intervention for a SDH at the Johns Hopkins Hospital between 1995 and 2010.


  • The mean age at admission was 71years.
  • All patients had St. Jude’s mechanical heart valves and were receiving anticoagulation therapy.
  • All patients had their anticoagulation reversed with vitamin K and fresh frozen plasma and underwent surgical evacuation.
  • Anticoagulation was withheld for a mean of 14days upon admission and a mean of 9days postoperatively.
  • The average length of stay was 19days.
  • No deaths or thromboembolic events occurred during the hospitalization.
  • Average follow-up time was 50months, during which two patients had a recurrent SDH.
  • No other associated morbidities occurred during follow-up.

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