• Fernando F Sánchez-Medina, Olivia Valenzuela-Antelo, Lucía C Valenzuela-Molina, Joel Arias-Martínez, Cruz M López-Morales, and José M Ornelas-Aguirre.
• Department of Cardiothoracic Surgery, Centro Médico Nacional del Noroeste, Instituto Mexicano del Seguro Social, Ciudad Obregón, Sonora.
• Gac Med Mex. 2023 Jan 1; 159 (3): 210218210-218.

BackgroundHeart valve replacement surgery with mechanical or biological prostheses entails a risk of thromboembolism and bleeding complications.ObjectiveTo determine the complications related to complementary anticoagulation therapy and the probability of risk.MethodsOne-hundred and sixty-three patients who underwent heart valve replacement between 2002 and 2016 with either mechanical or biological prostheses, and who received vitamin K antagonists after hospital discharge, were studied. Anticoagulation therapy was categorized into optimal and non-optimal according to INR values prior to the development of complications. Patients with comorbidities and other risk factors for thrombosis and/or bleeding were excluded.ResultsIn total, 68.7 % of patients received mechanical prostheses, and 31.3 %, biological prostheses (p ≤ 0.001); 25.2 % experienced the complications that motivated the study (p ≤ 0.001), which were hemorrhagic in 48.8 %, thromboembolic in 26.8 %, and of both types in 24.4 % (relative risk = 4.229). Among the patients with complications, 95.1 % received mechanical prostheses, and 4.9 %, biological (p = 0.005); non-optimal INR was identified in 49.7 % (p ≤ 0.001).ConclusionsGiven the high risk of thromboembolic and hemorrhagic complications, valve prostheses must be carefully chosen, and care priorities should include prevention and follow-up, especially in those patients who require anticoagulation therapy.Copyright: © 2023 Permanyer.

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