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Risk of Stroke and Major Bleeding with Vitamin-K Antagonist Use after Mitral Valve Repair
CONCLUSIONS: Our study suggests that VKA after MVr does not reduce risk of cerebral embolic events but is associated with increased risk of major bleeding events.PMID:36223805 | DOI:10.1016/j.athoracsur.2022.09.038
Source: The Annals of Thoracic Surgery - October 12, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Chase R Brown Alexandra E Sperry William G Cohen Jason J Han Fabliha Khurshan Peter Groeneveld Nimesh Desai Source Type: research

Long Term Outcomes and Anticoagulation in Mitral Valve Surgery - A Report from the Society of Thoracic Surgeons Database
CONCLUSIONS: Anticoagulation was used in less than half of mitral valve surgery. In MVrep patients, warfarin was associated with increased bleeding and was not protective against either stroke or mortality. In BMVR patients, warfarin was associated with a modest survival benefit, increased bleeding and equivalent stroke risk. NOAC was associated with increased adverse outcomes.PMID:37308066 | DOI:10.1016/j.athoracsur.2023.05.025
Source: The Annals of Thoracic Surgery - June 12, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Thomas A Schwann Andrew M Vekstein Daniel T Engelman Dylan Thibault Joanna Chikwe Milo Engoren Mario Gaudino Sreekanth Vemulapalli Vinod Thourani Gorav Ailawadi Anthony Rousou Robert H Habib Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulant vs Warfarin for Post Cardiac Surgery Atrial Fibrillation.
CONCLUSIONS: NOACs are associated with a reduction in post-operative LOS, without excess bleeding or other short-term complications, compared to warfarin. These findings support the broader use of NOACs as a safe alternative to warfarin in patients with post-cardiac surgery AF at elevated stroke risk and acceptable bleeding risk. PMID: 33440173 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - January 10, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Nauffal V, Trinquart L, Osho A, Sundt TM, Lubitz SA, Ellinor PT Tags: Ann Thorac Surg Source Type: research

Continued non-vitamin K antagonist oral anticoagulants versus vitamin K antagonists during transcatheter aortic valve implantation
CONCLUSIONS: Continued NOAC compared with continued VKA during TAVI led to comparable outcomes with regard to the composite outcome measure indicating that continued OAC with both drugs is feasible. These hypothesis-generating results need to be confirmed by a dedicated randomised controlled trial.PMID:36440479 | DOI:10.4244/EIJ-D-22-00521
Source: EuroIntervention - November 28, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Norman Mangner Miriam Brinkert Lukas S Keller Noriaki Moriyama Daniel Hagemeyer Stephan Haussig Lisa Crusius Richard Kobza Mohamed Abdel-Wahab Mika Laine Stefan Stortecky Thomas Pilgrim Fabian Nietlispach Frank Ruschitzka Holger Thiele Stefan Toggweiler A Source Type: research

Direct oral anticoagulants versus vitamin K antagonists: Which one is more effective in atrial fibrillation
CONCLUSIONS: Our meta-analysis demonstrates that in patients undergoing bioprosthetic valve surgery and presenting with AF afterward, DOAC and VKA are similar regarding life-threatening and all-cause mortality outcomes, including major bleeding, stroke, and intracranial hemorrhage.PMID:37697799 | DOI:10.1177/02676591231202383
Source: Perfusion - September 12, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Alireza Khodadadiyan Kimia Jazi Hamed Bazrafshan Drissi Helia Bazroodi Mina Mashayekh Erfan Sadeghi Ghazal Gholamabbas Mehdi Bazrafshan Mahdi Rahmanian Source Type: research

Dabigatran etexilate in a vitamin ‐K antagonist non responder patient during Heartware HVAD support
We report a case of a patient supported with a HeartWare left ventricular assist device for idiopathic cardiomyopathy who was resistance to vitamin‐K antagonists three months after implantation. The patient initially started low‐molecular‐weight heparin therapy and then, after the onset of an ischemic stroke, switched to dabigatran etexilate (DE). The patient had progressive recovery of cardiac function for which the device was explanted. No thrombotic or bleeding events occurred during DE therapy.
Source: Journal of Cardiac Surgery - December 31, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Andrea Baronetto, Paolo Centofanti, Matteo Attisani, Massimo Boffini, Davide Ricci, Erika Simonato, Mauro Rinaldi Tags: PERIOPERATIVE MANAGEMENT Source Type: research

Feasibility and safety of vitamin K antagonist monotherapy in atrial fibrillation patients undergoing transcatheter aortic valve implantation.
CONCLUSIONS: VKA therapy without additional antiplatelet treatment is effective and safe in AF patients undergoing TAVI. PMID: 28433958 [PubMed - in process]
Source: EuroIntervention - April 24, 2017 Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

New oral anticoagulants versus warfarin in atrial fibrillation after early post-operative period in patients with bioprosthetic aortic valve
CONCLUSIONS: In real-word, NOACs use overcomes the indications provided by guidelines. This study evidenced that NOACs use in patients who developed AF after bioprosthetic AVR was more effective in prevention of thromboembolism and safe in reduction of major bleeding events compared to warfarin.PMID:33744222 | DOI:10.1016/j.athoracsur.2021.03.016
Source: The Annals of Thoracic Surgery - March 21, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Vito A Mannacio Luigi Mannacio Anita Antignano Ciro Mauro Pasquale Mastroroberto Francesco Musumeci Carlo Zebele Gabriele Iannelli Source Type: research

Commentary: Direct oral anticoagulants in heart surgery: A  question in need of an answer
The Invited Expert Opinion by Drs Kapadia and Svensson1 is focused on an important clinical challenge of whether direct oral anticoagulants (DOACs) can be used in patients with bioprosthetic valves who have atrial fibrillation (AF). Recommendations for anticoagulation therapy should focus on potential risks of early postoperative bleeding with DOAC treatment and not only on its long-term superiority over vitamin K antagonists (VKAs) for stroke prevention in patients with AF, with or without a bioprosthetic valve.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 10, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Stephen D. Waterford, Niv Ad Tags: Commentary Source Type: research

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