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

Neurocritical Care , 04/17/2012

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.

Methods

  • 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.

Results

  • 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.

Print Article Summary Cat 2 CME Report