Long-term bleeding events after mechanical aortic valve replacement in patients under the age of 60Report as inadecuate

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Netherlands Heart Journal

, Volume 23, Issue 2, pp 111–115

First Online: 19 November 2014DOI: 10.1007-s12471-014-0626-9

Cite this article as: Swinkels, B.M., de Mol, B.A., Kelder, J.C. et al. Neth Heart J 2015 23: 111. doi:10.1007-s12471-014-0626-9


BackgroundAlthough younger patients are supposed to be less susceptible to bleeding complications of mechanical aortic valve replacement mAVR than older patients, there is a relative paucity of data on this subject. Therefore, it remains uncertain whether younger patients are really at a lower risk of these complications than older patients.

MethodsIncidence rates of bleeding events during 15 years of follow-up after mAVR were compared between 163 patients under 60 group I, 122 patients between 60 and 65 group II, and 145 patients over 65 group III years of age at operation. The target international normalised ratio INR was 3.0–4.0.

ResultsDuring 15 years of follow-up, the annual incidence rate of major bleeding events excluding haemorrhagic stroke was lower in the youngest as compared with the oldest group 3.0 versus 4.7 %, respectively; p = 0.030. However, the annual incidence rate of haemorrhagic stroke was as high in the youngest as in the two older groups 0.6 versus 0.7 % and 0.7 %, respectively; p = 0.928.

ConclusionsWith a target INR of 3.0–4.0, patients under 60 years of age are at equally high risk of haemorrhagic stroke after mAVR as older patients. This finding confirms the relevance of a lower target INR as used in international guidelines.

KeywordsAortic valve Heart valve prosthesis Intracranial haemorrhage Coumarin  Download fulltext PDF

Author: B. M. Swinkels - B. A. de Mol - J. C. Kelder - F. E. Vermeulen - J. M. ten Berg

Source: https://link.springer.com/

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