Work

Safety of parenteral anticoagulation as a bridge to warfarin in patients undergoing mechanical aortic valve replacement

Year: 2025

Type: article

Abstract: Objective: To evaluate bleeding rates among patients who received a mechanical aortic valve replacement (mAVR) treated with warfarin monotherapy versus warfarin with a therapeutic parenteral anticoagulant bridge. Methods: This retrospective, single-center, observational study included patients at least 18 years old who received an mAVR and had anticoagulation ordered by the end of postoperative day 2. Exclusion criteria included an INR goal other than 2-3, a hypercoagulable state, postoperative mechanical circulatory support, delayed sternal closure, pregnancy or incarceration. The primary outcome was International Society of Thrombosis and Hemostasis major bleeding until hospital discharge or 30 days after valve replacement, whichever came first. Secondary outcomes included thromboembolic events, hospital length of stay, and mortality. Results: = .99). Conclusions: The use of therapeutic parenteral anticoagulation with warfarin after mAVR significantly increased the rate of major bleeding compared to warfarin monotherapy. Larger prospective studies are needed to confirm these findings.

Source: JTCVS Open

DOI: 10.1016/j.xjon.2025.09.020

Authors: Liz Mann, Bryan A. Whitson, Eric McLaughlin, Laura Andino, Alan Rozycki

Institutions: The Ohio State University Wexner Medical Center, The Ohio State University, Beth Israel Deaconess Medical Center

Language: English

Topic: Cardiac Valve Diseases and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,431