scholarly journals Evaluation of hemostasis parameters after mitral valve replacement surgery with mechanical prostheses in patients with different treatment adherence

2021 ◽  
pp. 20-24
Author(s):  
M. M. Markova ◽  
O. S. Polunina ◽  
D. G. Tarasov ◽  
M. A. Kiseleva ◽  
E. A. Polunina
Keyword(s):  
Mitral Valve ◽  
International Normalized Ratio ◽  
Activated Partial Thromboplastin Time ◽  
Adherence To Treatment ◽  
Replacement Surgery ◽  
Mechanical Prostheses ◽  
The Relationship ◽  
D Dimer ◽  
Valve Replacement Surgery

The aim of the study. To analyze the indicators of hemostasis with adherence to treatment in patients operated on for mitral valve prosthetics with mechanical bicuspid prostheses in dynamics after 6, 12 and 60 months.Materials and methods. The study included 260 patients who underwent surgery for prosthetics with mechanical prostheses. Patients’ adherence to treatment was assessed using the Morisky – Green test. The following hemostasis parameters were analyzed: international normalized ratio (INR), activated partial thromboplastin time (APTT), D-dimer, fibrinogen and soluble fibrin-monomer complexes.Results of the study and conclusion. At all stages of the postoperative period, the hemostasis indicators of compliant patients corresponded to the reference values for people receiving anticoagulants, in non-compliant patients, these indicators did not reach the recommended values for patients on anticoagulant therapy. The presence of correlations between compliance and hemostasis indicators is evidenced by the results of correlation analysis. In most cases, the maximum strength of the relationship between compliance and hemostasis indicators was observed after 12 months of follow-up. A noticeable strength of interrelations was traced between compliance and levels of APTT, INR and fibrinogen.

Results of Valve Replacement Surgery with Mechanical Prostheses

1982 ◽  
Vol 5 (1) ◽  
pp. 27-32 ◽  
Author(s):  
A. Pellegrini ◽  
B. Peronace ◽  
E. Marcazzan ◽  
C. Rossi ◽  
T. Colombo
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Replacement Surgery ◽  
Post Surgery ◽  
Mechanical Prostheses ◽  
Valve Replacement Surgery

The clinical study is reported of the results of heart valve replacement surgery with a new pyrolytic carbon tilting disc prosthesis manufactured in Italy. From March 1977 to January 1981, at the «De Gasperis» Cardiosurgery Center, this prosthesis has been implanted in 644 patients: 283 for mitral valve replacement, 240 for aortic valve replacement, and 121 for the replacement of both mitral and aortic valves. To have a sufficiently long period of post-surgery follow-up, we considered the results of 207 patients (124 cases of isolated mitral valve replacement and 83 cases of isolated aortic valve replacement), who underwent surgery consecutively from March 1977 to December 1979. The hospital mortality was 10.5% for mitral valve replacement and 4.8% for aortic valve replacement. All patients who were discharged from hospital, except 2, were subjected to clinical, electrocardiographic, phonocardiographic, ecocardiographic and radiological checks. The average follow-up period was approximately 20 months: clinical results were satisfactory. The probability of survival, expressed by actuarial curve, was, three years after surgery, 94% for patients who underwent mitral valve replacement and 97.5% for those who underwent aortic valve replacement. The probability of embolism was, three years after surgery, 8.5% for patients with mitral replaced and 5% for aortic. Even if further confirmations are needed the mortality rate and the probability of embolism related to this new prosthesis, are lower, over the same period of follow-up, than that found in the groups of patients who underwent valve replacement surgery, at the same Center, with Starr-Edwards and Björk-Shiley prostheses. The phonocardiographic and ecocardiographic characteristics of this new prosthesis were also investigated.

De Ritis ratio as a significant prognostic factor of international normalized ratio ≥4 in the initial 10 days of warfarin therapy

2019 ◽  
Vol 13 (18) ◽  
pp. 1599-1607
Author(s):  
Yide Cao ◽  
Ganyi Chen ◽  
Huangshu Li ◽  
Yafeng Liu ◽  
Zhonghao Tao ◽  
...  
Keyword(s):  
Valve Replacement ◽  
Heart Valve ◽  
Warfarin Therapy ◽  
Anticoagulation Therapy ◽  
International Normalized Ratio ◽  
Heart Valve Replacement ◽  
Significant Prognostic Factor ◽  
Replacement Surgery ◽  
The Relationship ◽  
Valve Replacement Surgery

Aim: To assess the relationship between the De Ritis ratio on admission and warfarin sensitivity in the initial 10 days of anticoagulation therapy. Methods: We retrospectively reviewed data from 906 patients who underwent heart valve replacement surgery. Results: A De Ritis ratio of 1.19 was identified as the optimal cutoff according to the ROC curve. Patients with a high De Ritis ratio achieved an international normalized ratio (INR) ≥4 more easily and earlier than those with a low De Ritis ratio in the initial 10 days of warfarin therapy. Multivariate analysis showed that a high De Ritis ratio was an independent predictor of an INR ≥4 (HR: 2.567; p < 0.001). Conclusion: A De Ritis ratio ≥1.19 on admission was significantly associated with an INR ≥4 in the initial 10 days of warfarin therapy among patients underwent heart valve replacement surgery.

RELATIONSHIP OF PREOPERATIVE RIGHT VENTRICULAR FUNCTION AND OUTCOME AFTER MITRAL VALVE REPLACEMENT SURGERY – A PROSPECTIVE OBSERVATIONAL STUDY

2020 ◽  
pp. 43-46
Author(s):  
Debashis Karmokar ◽  
Pinaki Majumdar ◽  
Manjushree Ray ◽  
Asim Kumar Kundu
Keyword(s):  
Mitral Valve ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Right Ventricular Function ◽  
Low Cardiac Output Syndrome ◽  
Replacement Surgery ◽  
Grade 3 ◽  
Valve Replacement Surgery

Objective:Right ventricular dysfunction constitutes a major risk factor for patients suffering from degenerative mitral valve disease. The objective of this study was to assess right ventricular function by echocardiography and to detect role of right ventricular functions in prediction of outcome following mitral valve replacement operation in patients with rheumatic heart disease involving mitral valve. Methods:Transthoracic 3D echocardiography was done in 52 patients posted for mitral valve replacement surgery. Right ventricular function was analyzed by measuring fractional area change (FAC) of right ventricle, tethering distance and, tricuspid annular plane systolic excursion (TAPSE). Tricuspid regurgitation was graded 0 to 4. Based on echocardiographic ndings of right ventricle, patients were allocated in two groups; Group A (normal right ventricular function) and Group B (poor right ventricular function). After surgery, incidence of complications such as; low cardiac output syndrome, refractory arrhythmia and, sepsis were compared in two group. Results: Incidence of postoperative complication such as low cardiac output syndrome and sepsis was signicantly more in patients with poor right ventricular function. Right ventricular variables, FAC <35%, TAPSE <17 mm and tethering distance > 8 mm are independent predictors of postoperative complications. Tricuspid valve was repaired in patients with grade 3 and 4 regurgitation. Therefore cardiopulmonary bypass time was signicantly more in patients with grade 3 and 4 TR (84.42±69.77 min) (p<0.01). Duration of intensive care support was also signicantly more in patients with poor right ventricular function (p<0.001) Conclusion: To predict possible complications and outcome following mitral valve replacement surgery, right ventricular functions should be thoroughly assessed by 3D echocardiography

Giant Left Ventricular Pseudoaneurysm as a Complication After Mitral Valve Replacement Surgery

2014 ◽  
Vol 98 (4) ◽  
pp. 1480 ◽  
Author(s):  
Stefan Baumann ◽  
Matthias Renker ◽  
James V. Spearman ◽  
Richard R. Bayer ◽  
U. Joseph Schoepf ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Ventricular ◽  
Left Ventricular Pseudoaneurysm ◽  
Replacement Surgery ◽  
Valve Replacement Surgery

scholarly journals ASSESSMENT OF COAGULATION PROFILE IN PATIENTS WITH LIVER CIRRHOSIS AND ATRIAL FIBRILLATION

2021 ◽  
Vol 121 (1) ◽  
pp. 22-31
Author(s):  
Alіna Baylo ◽  
Vadym Shypulіn ◽  
Volodymyr Chernyavskyi ◽  
Luiza Parunyan
Keyword(s):  
Atrial Fibrillation ◽  
Liver Cirrhosis ◽  
Prothrombin Time ◽  
Partial Thromboplastin Time ◽  
International Normalized Ratio ◽  
Activated Partial Thromboplastin Time ◽  
Fibrinolytic System ◽  
Thrombin Time ◽  
Group I ◽  
D Dimer

The comorbid course of liver cirrhosis and atrial fibrillation causes higher levels of hospitalizations, mortality and ischemic stroke. According to current data, hemostasis in patients with liver cirrhosis is in a rebalanced dynamic state, but there are no data on the effect of atrial fibrillation on the hemostasis in patients with liver cirrhosis. Aims of the study. To assess abnormalities in primary, secondary haemostasis and fibrinolytic system in patients with liver cirrhosis and atrial fibrillation by using standard laboratory coagulation parameters and to investigate their changes depending on the stage of liver cirrhosis A, B, C according to Child-Pugh score. Materials and methods. A cross-sectional prospective study was conducted with the inclusion of 106 patients aged 42 to 83 years: group I (n = 70) - with liver cirrhosis and atrial fibrillation, II (n = 36) - with liver cirrhosis, which were distributed depending on the Child-Pugh score stages of cirrhosis and 20 healthy individuals. The levels of platelets, activated partial thromboplastin time, international normalized ratio, prothrombin time, thrombin time, fibrinogen, D-dimer were assessed on a Steellex M200 coagulometer. Statistical analysis (IBM SPSS Statistics) was performed. Results. The level of platelets in patients of group I was reduced by 37.4% (200 ± 8.33 vs. 274.7 ± 3.4; p,000.001), an activated partial thromboplastin time was prolonged by 38.6% (44.35 ± 1.39 vs. 32.01 ± 0.63, p˂0.001), prothrombin time was prolonged by 73.5% (19.4 ± 0.87 vs. 11.18 ± 0.53, p˂0.001), thrombin time was prolonged by 2.07 (25, 7 ± 1.31 vs. 12.4 ± 0.66, p˂0.001), the international normalized ratio was increased by 24.3% (1.38 ± 0.04 vs.1.11 ± 0.01, p˂0.001) compared to control. The fibrinogen level was 20.9% higher (4.17 ± 0.17 vs. 3.45 ± 0.11, p˂0.001) than in control group and was 83.7% higher (4.17 ± 0.17 vs. 2.27 ± 0.13, p˂0.001) than in group II. The D-dimer level was 83% higher than in control (675 ± 22.3 vs. 368.8 ± 21.85, p˂0.001) and 44% higher (675 ± 22.3 vs. 469 ± 37.18, p ˂0.001) compared with group II. Conclusions. In patients with liver cirrhosis and atrial fibrillation abnormalities of primary hemostasis are detected due to decrease of platelets on the background of portal hypertension. At the secondary stage of hemostasis indicators of external and internal coagulation mechanisms are prolonged due to the reduced synthesis of coagulation factors by the liver. Increased level of fibrinogen is determined at the stage of compensated and subcompensated cirrhosis with a gradual decrease at the stage of decompensation. The high activity of the fibrinolytic system is observed due to increase in the D-dimer levels, which may indicate a prothrombotic state in these patients.

scholarly journals Role of per-operative milrinone on pulmonary hypertension having mitral valve replacement.

2021 ◽  
Vol 28 (01) ◽  
pp. 120-124
Author(s):  
Shahbaz Ahmad Khilji ◽  
Shuja Tahir ◽  
Shahid Abbas
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Nyha Class ◽  
Control Group ◽  
Study Group ◽  
Replacement Surgery ◽  
Valve Replacement Surgery

Objective: To determine the role of perioperative milrinone on pulmonary hypertension in patients with mitral valve disease undergoing mitral valve replacement surgery. Study Design: Randomized Control Trial. Setting: Department of Cardiac Surgery, Faisalabad Institute of Cardiology, Faisalabad. Period: June 2019 to June 2020. Material & Methods: A total of 80 patients with mitral valve disease who underwent mitral valve replacement were included. The patients were divided into a control group of 40, who were not administered milrinone, and a study group of 40 who received milrinone perioperatively. TVPG, LVEF and NYHA class were recorded preoperatively and postoperatively and were compared. Results: In the study group, postoperative LVEFs and NYHA class were not statistically significant in both groups while postoperative TVPG was significantly lower in study group as compare to control group and is statistically significant (P<0.001). Conclusion: Our study concludes that milrinone can be used as an effective therapy to reduce pulmonary pressure in patients with pulmonary hypertension undergoing mitral valve replacement surgery.

scholarly journals Inflammatory Burden and Persistent CT Lung Abnormalities in COVID-19 Patients

2021 ◽  
Author(s):  
Giulia Besutti ◽  
Paolo Giorgi Rossi ◽  
Marta Ottone ◽  
Lucia Spaggiari ◽  
Simone Canovi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Length Of Hospital Stay ◽  
Lung Damage ◽  
Reactive Protein ◽  
Lung Abnormalities ◽  
The Relationship ◽  
Lung Ct ◽  
D Dimer ◽  
Inflammatory Burden

Abstract Inflammatory burden is associated with COVID-19 severity and outcomes. Residual computed tomography (CT) lung abnormalities have been reported after COVID-19. The aim was to evaluate the association between inflammatory burden during COVID-19 and residual lung CT abnormalities collected on follow-up CT scans performed 2–3 and 6–7 months after COVID-19, in severe COVID-19 pneumonia survivors. C-reactive protein (CRP) curves describing inflammatory burden during the clinical course were built, and CRP peaks, velocities of increase, and integrals were calculated. Other putative determinants were age, sex, mechanical ventilation, lowest PaO2/FiO2 ratio, D-dimer peak, and length of hospital stay (LOS). Of the 259 included patients (median age 65 years; 30.5% females), 202 (78%) and 100 (38.6%) had residual, predominantly non-fibrotic, abnormalities at 2-3 and 6-7 months, respectively. In age- and sex-adjusted models, best CRP predictors for residual abnormalities were CRP peak (odds ratio [OR] for one standard deviation [SD] increase=1.79; 95% confidence interval [CI]=1.23-2.62) at 2-3 months and CRP integral (OR for one SD increase=2.24; 95%CI=1.53-3.28) at 6-7 months. Hence, inflammation is associated with short- and medium-term lung damage in COVID-19. Other severity measures, including mechanical ventilation and LOS, but not D-dimer, were mediators of the relationship between CRP and residual abnormalities.

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