Nazmiye Selçuk KAPISIZ, Fahri KAPISIZ, ORHAN VELİ DOĞAN, Melahat TOKER, Ertan YÜCEL

Management of intracranial bleeding in patients with mechanical heart valves: Three case reports and a study of the literature

Bu çalışmada mekanik kalp kapağı olan hastalarda gelişen intrakraniyal kanamaya yaklaşım incelendi. İntrakraniyal kanama geçiren mekanik kalp kapaklı üç olgu çalışmaya alındı. Bu hastalara tedavi yaklaşımı tartışıldı ve oral antikoagulan tedavi altındaki prostetik kalp kapaklı hastalarda intrakraniyal kanamanın tedavisi ile ilgili literatür bilgileri gözden geçirildi.

Anahtar Kelimeler:

Orta yaşlı, Yaşlı, Erişkin, Tromboembolizim, Kadın, Kafa içi kanamalar, Kalp kapağı protezleri, Kalp kapakları

Mekanik kalp kapağı olan hastalarda intrakraniyal kanamaya yaklaşım: Üç olgu sunumu ve literatür çalışması

In this study, we examined the approachto intracranial bleeding in patients with mechanical heart valves. Three patients with mechanical heart valves and intracranial hemorrhage were included in the study. We discussed the therapeutic approach to these patients and reviewed the literature on the treatment of intracranial bleeding in patients on oral anticoagulation with prosthetic heart valves.

Keywords:

Middle Aged, Aged, Adult, Thromboembolism, Female, Intracranial Hemorrhages, Heart Valve Prosthesis, Heart Valves,

PDF

___

1) Cannegieter SC, Rosendaal FR, Briet E. Thromboembolic and bleeding complications in patients with mechanical heart valve prostheses. Circulation 1994;89:635-41.
2) Unverir P, Dağ T, Peynirci H, Demir E, Canbay C, Kaya A, et al. An analysis of bleeding complications related to warfarin in the emergency department. Turk J Emerg Med 2006;6:117-21.
3) Hart RG, Boop BS, Anderson DC. Oral anticoagulants and intracranial hemorrhage. Facts and hypotheses. Stroke 1995;26:1471-7.
4) Cannegieter SC, Torn M, Rosendaal FR. Oral anticoagulant treatment in patients with mechanical heart valves: how to reduce the risk of thromboembolic and bleeding complications. J Intern Med 1999; 245:369-74.
5) Lee LH. Thrombotic and haemorrhagic complications in patients with mechanical heart valve prostheses attending the Singapore General Hospital Anticoagulation Clinic. Ann Acad Med Singapore 2000;29:71-4.
6) Crawley F, Bevan D, Wren D. Management of intracranial bleeding associated with anticoagulation: balancing the risk of further bleeding against thromboembolism from prosthetic heart valves. J Neurol Neurosurg Psychiatry 2000;69:396-8.
7) Ananthasubramaniam K, Beattie JN, Rosman HS, Jayam V, Borzak S. How safely and for how long can warfarin therapy be withheld in prosthetic heart valve patients hospitalized with a major hemorrhage? Chest 2001;119:478-84.
8) Phan TG, Koh M, Wijdicks EF. Safety of discontinuation of anticoagulation in patients with intracranial hemorrhage at high thromboembolic risk. Arch Neurol 2000;57:1710-3.
9) Lazio BE, Simard JM. Anticoagulation in neurosurgical patients. Neurosurgery 1999;45:838-47.
10) Butler AC, Tait RC. Restarting anticoagulation in prosthetic heart valve patients after intracranial haemorrhage: a 2-year follow-up. Br J Haematol 1998;103:1064-6.
11) Laohaprasit V, Mayberg MR. Risks of anticoagulation therapy after experimental corticectomy in the rat. Neurosurgery 1993;32:625-8.
12) Katholi RE, Nolan SP, McGuire LB. The management of anticoagulation during noncardiac operations in patients with prosthetic heart valves. A prospective study. Am Heart J 1978;96:163-5