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Antithrombotic therapy after bioprosthetic aortic valve replacement: ACTION Registry survey results

^a Department of Cardiovascular Surgery, Hospital Clinic, Barcelona, Spain
^b Department of Cardio-Vascular and Thoracic Surgery, University of Rennes, France
^c Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
^d Department of Cardiac and Thoracic Surgery, University of Cologne, Germany
^e Department of Cardiac Surgery, The Royal Sussex County Hospital, United Kingdom
^f Department of Cardiothoracic Surgery, University Hospital Birmingham, United Kingdom
^g Department of Cardiothoracic Surgery, University Hospital, Coimbra, Portugal
^h Department of Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany
ⁱ Department of Cardiothoracic Surgery, Wessex Cardiothoracic Centre, Southampton General Hospital, Southampton, United Kingdom
^j Department of Thoracic, Cardiac and Vascular Surgery, University of Tübingen, Germany
^k Department of Cardiovascular Surgery, Pitié Salpêtrière Hospital, University Pierre et Marie Curie, France
^l Department of Cardio-Thoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands
^m Department of Cardiac Surgery, University of Parma, Italy

Received 7 September 2007; received in revised form 1 December 2007; accepted 10 December 2007.

^_* Corresponding author at: Hospital Clinic, C. Villaroel 170, 08036 Barcelona, Spain. Tel.: +34 687203754. (Email: colli.andrea{at}libero.it).

Aims: A variety of antithrombotic regimens have been described for the early postoperative period after bioprosthetic aortic valve replacement (AVR). This study reviews antithrombotic practice for patients undergoing bioprosthetic AVR with or without coronary artery bypass graft (CABG) amongst the centers participating in the ACTION (Anticoagulation Treatment Influence on Postoperative Patients) Registry. Methods and results: An antithrombotic therapy questionnaire was answered by the 49 centers participating in the ACTION Registry located in Europe, Middle East, Canada and Asia. The 43% of centers prescribe vitamin K antagonist (VKA), 20% prescribe VKA and acetyl salicylic acid (ASA), 33% prescribe only ASA and 4% do not prescribe any therapy after bioprosthetic AVR. For patients undergoing bioprosthetic AVR and CABG 39% of the centers prescribe VKA and ASA, 37% prescribe VKA and 24% prescribe ASA. After the first three postoperative months following bioprosthetic AVR, 61% of the centers prescribe only ASA, while 39% do not prescribe any therapy. Patients with bioprosthetic AVR and CABG receive ASA in 90% centers, in 2% centers VKA and ASA, and 8% centers do not prescribe any antithrombotic. Conclusion: This study demonstrates that, despite guidelines published by several professional societies, medical practice for the prevention of thrombotic events early after bioprosthetic AVR varies widely among cardiac surgical centers.

Key Words: Anticoagulants • Antiplatelet drugs • Antithrombotic therapy • Acetyl salicylic acid • Aortic bioprosthetic valve

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				J. I. Aramendi and C.-A. Mestres Antithrombotic therapy after bioprosthetic aortic valve replacement Eur. J. Cardiothorac. Surg., April 1, 2008; 33(4): 529 - 530. [Full Text] [PDF]