Perioperative Bleeding and Thromboembolic Risk during Non-Cardiac Surgery
in Patients with Mechanical Prosthetic Heart Valves: An Institutional Review

Thierry P. Carrel MD, Wulf Klingenmann MD, Paul J. Mohacsi MD,
Pascal Berdat MD, Ulrich Althaus MD

A series of 235 patients with mechanical heart valve prostheses undergoing subsequent non-cardiac surgery are reported. Perioperative management of anticoagulation included several approaches: from no withdrawal of oral anticoagulant to discontinuation of coumarins, with or without perioperative heparin therapy. Thromboembolic and bleeding complications occurred in 34 patients (14.5%). A majority of embolic events occurred after hospital discharge.

392