Supra ‐annular valve strategy for an early degenerated transcatheter balloon‐expandable heart valve
In this report, we describe the use of a supra‐annular valve strategy for an early degenerated THV.
ConclusionsIn this study, the complex flow field characteristics in the new generation of BMHVs considering aorta flexibility with healthy and calcified annulus were investigated. It was found that the blood flow around the hinges region is in the danger of hemolysis and platelet activation and subsequently thromboembolism. Furthermore, the results show that similar to vessel wall deformation, considering the probable annulus calcification after valve replacement is also essential.
Rationale: Heart-valve replacement is one of the main surgical methods for various heart-valve diseases. Warfarin is the only oral anticoagulant used for thrombosis prevention after heart-valve replacement. However, warfarin has a narrow therapeutic window, large differences in efficacy between individuals, and can be affected by drugs, food and disease status. Patient concerns: We used the Hamberg model to develop an anticoagulation regimen for a 10-month-old Chinese male after mitral-valve replacement. Diagnoses: Echocardiography revealed mitral malformation with severe regurgitation, patent foramen ovale, thicke...
Conclusion: Our meta-analysis suggests that LMWH not only reduces the risk of thromboembolism in patients with MHV but also does not increase the risk of major bleeding. LMWH may provide safer and more effective bridging anticoagulation than UFH in patients with MHV. It is still necessary to conduct future randomized studies to verify this conclusion.
We report a case of successful long‐term anticoagulation with enoxaparin in a patient with a mechanical aortic valve who had a contraindication to warfarin. The patient developed a left thigh hematoma requiring surgical evacuation one month after initiation of weight‐based dosing of e noxaparin. His dose was then titrated based on peak anti–Xa levels (goal 0.6–1.0 IU/mL). He remained free of signs and symptoms of thromboembolic events, valve dysfunction, bleeding complications, or major adverse effects from long‐term enoxaparin use for the next 13 years. Our case provides p romising evidence of the potent...
Conclusion After TAVI with Edwards Sapien valve OAT did not reduce the incidence of valve dysfunction and stroke but was responsible for mortality and bleeding increases.
ConclusionsWhereas warfarin suppresses MHV-induced thrombin generation, MHVs induce the generation of factor Xa in concentrations that overwhelm clinically relevant concentrations of rivaroxaban or apixaban. When used in combination, rivaroxaban and dabigatran are more effective than either agent alone suggesting that concomitant inhibition of factor Xa and thrombin is better than inhibition of either clotting enzyme alone.
CONCLUSIONS: Whereas warfarin suppresses MHV-induced thrombin generation, MHVs induce the generation of factor Xa in concentrations that overwhelm clinically relevant concentrations of rivaroxaban or apixaban. When used in combination, rivaroxaban and dabigatran are more effective than either agent alone suggesting that concomitant inhibition of factor Xa and thrombin is better than inhibition of either clotting enzyme alone. PMID: 31877292 [PubMed - as supplied by publisher]
CONCLUSIONS: In order to achieve optimal outcomes by maintaining effective anticoagulant dosing while entailing minimal risk in Chinese patients that have undergone a bileaflet mechanical valve replacement, the target INR range should be between 1.5 and 2.5, with the final intensity of this anticoagulant regimen being determined based on a given patient's risk of thromboembolism. PMID: 31866562 [PubMed - as supplied by publisher]
CONCLUSIONS: These results establish retinoid regulation of human cardiovascular calcification, provide new insight into mechanisms involved in these responses, and suggest selective retinoid modulators, like acyclic retinoids may allow for treating cardiovascular calcification without the adverse effects associated with cyclic retinoids. PMID: 31852220 [PubMed - as supplied by publisher]
Cardiology MCQ – Anticoagulation in pregnancy – Answer My Cardiology MCQ books on Amazon Best maternal outcomes in mechanical prosthetic valves with pregnancy is obtained with: Correct answer: 3. Warfarin Best maternal outcome in pregnancy with mechanical prosthetic valves is obtained with warfarin . But it is a known teratogen and is associated with lowest number of live births. Low molecular weight heparin probably gives the best fetal outcome, though the maternal risk of thromboembolism is higher. Dabigatran is not recommended for mechanical prosthetic valves even without pregnancy. Generally warfarin is...