Abstract
— Patients with prosthetic heart valves must be kept free from blood clots due to the high thromboembolic risk. Whenever these patients need to be operated, inadequate control of coagulation may lead to a high risk of haemorrhage or thrombosis. From January 1990 to December 1994, 59 patients with prosthetic heart valves undergoing chronic therapy with oral anticoagulants were treated in our Unit. Until December 1993 patients were treated with calcium heparine s.c., suspending the oral anticoagulant; this group showed a high risk of haemorrhage even with normal PTT values. In fact 19% of patients required blood transfusions while 8% had to be treated for haemorraghic complications. From January 1994 onwards, anticoagulant therapy has been changed to using intravenous heparin sodium, reducing the difficulties in monitoring and eliminating the characteristic side effects of calcium heparine s.c. therapy. There have been no haemorrhagic complications in this second group.
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