The Study On Perioperative Anticoagulant Therapy For Other Operation In Patients After Cardiac Valve Replacement

Objective Summarizing the outcomes of perioperative bridging anticoagulation and continued warfarin therapy in patients underwent heart valve replacement,the efficacy of two therapies,and postoperative hemorrhagic-related complications and embolism-related complications were compared.Methods A retrospective cohort study was conducted to review the clinical data of 56 patients who underwent surgical / invasive operation after cardiac valve replacement from January 2016 to January 2018.According to the different anticoagulant methods in perioperative period,the patients were divided into bridging group(n = 32)and continued group(n = 24).The length of postoperative hospitalization and the person of blood transfusion were compared between the two groups.After followed up thirty days,the patient,s hemorrhagic-related complications and embolism-related complications were collected.According to the perioperative risk of embolization,each group was divided into high risk subgroup,middle risk subgroup and low risk subgroup while comparing the complications of each subgroup to guide the perioperative treatment of different subgroups.Results(1)The length of hospitalization in the bridging group was significantly longer than that in the continued group(P < 0.05),but there was no significant difference in the person of blood transfusions after operation(P > 0.05);(2)After followed up thirty days,there was no significant difference between bridging anticoagulation and in the incidence of hemorrhagic-related complications and embolism-related complications(P > 0.05);(3)The incidence of hemorrhagic related complications associated with non-bridging group of high risk subgroup was significantly higher than that of continued group(P < 0.05);(4)The incidence of hemorrhagic related complications in bridging group was close to that in embolism-related complications(6.2% vs 5.6%),but the incidence of hemorrhagic-related complications in continued group was seven times higher than that embolism-related complications(29.2% vs 4.2%).Conclusions(1)Bridging anticoagulation increases patient,s length of hospitalization comparing to continued warfarin therapy;(2)there was no significant difference in the incidence of hemorrhagic-related complications and embolism-related complications comparing with bridging anticoagulation and continued warfarin therapy;(3)it is more beneficial for the patients with high embolization risk factors to apply bridging anticoagulation;(4)The incidence of hemorrhagic-related complications associated with continued warfarin therapy was significantly higher than that of embolism-related complications,and hemostatic drugs can be given necessarily.