Safety of withholding anticoagulation in patients with mechanical prosthetic valves and intracranial haemorrhage
Internal Medicine Journal, 10/12/2011
Krittalak K et al. – Discontinuation of anticoagulation in patients with prosthetic heart valves and intracranial haemorrhage for less than 7 days was associated with low thromboembolic risk and there was no clinical evidence of prosthetic heart valve dysfunction when anticoagulation was withheld for less than 14 days.Methods
- Retrospective descriptive study was conducted in 26 prosthetic heart valve patients hospitalised in Srinagarind Hospital, Khon Kaen University because of intracranial haemorrhage from 2003 to 2008.
- Range of anticoagulation withholding was 1 to 26 days with mean 8.5±7.7 days.
- Most patients (84.6%) were withheld anticoagulation for less than 14 days.
- There were five in-hospital deaths mostly within 3 days of admission from severe intracranial haemorrhage.
- No data of reintroduction of anticoagulation was found in three patients because they were lost to follow up.
- One patient had right basal ganglia infarction after 7 days of anticoagulation withholding.
- Prosthetic heart valve dysfunction was suspected in one patient who withheld anticoagulant for 76 days.