Enoxaparin for Early Anticoagulation after Mitral Valve Repair
Younes Moutakiallah *
Faculty of Medicine and Pharmacy of Rabat, Department of Cardiac surgery, Mohammed V University, Mohammed V Military Hospital, Rabat, Morocco
Roland Henaine
Faculty of Medicine Lyon Est, University of Claude Bernard Lyon 1, Hospices Civils de Lyon, Groupement Hospitalier Est, Hôpital Cardiologique Louis Pradel, Cardiac Surgery Unit, Lyon, France
Mehdi Bamous
Faculty of Medicine and Pharmacy of Rabat, Department of Cardiac surgery, Mohammed V University, Mohammed V Military Hospital, Rabat, Morocco
Jacques Robin
Faculty of Medicine Lyon Est, University of Claude Bernard Lyon 1, Hospices Civils de Lyon, Groupement Hospitalier Est, Hôpital Cardiologique Louis Pradel, Cardiac Surgery Unit, Lyon, France
Jean Ninet
Faculty of Medicine Lyon Est, University of Claude Bernard Lyon 1, Hospices Civils de Lyon, Groupement Hospitalier Est, Hôpital Cardiologique Louis Pradel, Cardiac Surgery Unit, Lyon, France
Jean-François Obadia
Faculty of Medicine Lyon Est, University of Claude Bernard Lyon 1, Hospices Civils de Lyon, Groupement Hospitalier Est, Hôpital Cardiologique Louis Pradel, Cardiac Surgery Unit, Lyon, France
*Author to whom correspondence should be addressed.
Abstract
Introduction: Despite recent progress and technological advances, heart valve surgery remains associated with a high rate of thromboembolic complications requiring anticoagulation, which must be both safe and effective to prevent any thromboembolic or bleeding events.
Objectives: The objective of this study was to verify the efficacy and the safety of Low Molecular Weight Heparin followed by vitamin K antagonists for the early anticoagulation after mitral valve repair.
Patients and Methods: This work was conducted as a prospective study. We selected 120 consecutive patients who underwent mitral valve repair and received enoxaparin as bridge between continuous unfractionated heparin and fully effective vitamin K antagonist therapy. The mean age was 63.6±13.5 years (15-84 years).
Results: There was no in-hospital mortality. One bleeding event (0.8%) was described: a right haemothorax drained percutaneously with transfusion and no thrombo-embolic events.
Conclusion: Low molecular weight heparin enoxaparin as bridging therapy between immediate postoperative unfractionated heparin and complete efficacy of oral anticoagulants may be considered as an option for the prevention of thromboembolic events in patients recently undergoing mitral valve repair.
Keywords: Early anticoagulation, mitral valve repair, low molecular weight heparin