Thromboembolic and hemorrhagic complications in patients with prosthetic heart valves cared for in a tertiary care center. What have we learned?

Fernando F. Sánchez-Medina, Olivia Valenzuela-Antelo, Lucía C. Valenzuela-Molina, Joel Arias-Martínez, Cruz M. López-Morales, José M. Ornelas-Aguirre

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1 Scopus citations


BACKGROUND: Heart valve replacement surgery with mechanical or biological prostheses entails a risk of thromboembolism and bleeding complications. OBJECTIVE: To determine the complications related to complementary anticoagulation therapy and the probability of risk. METHODS: One-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. RESULTS: In 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). CONCLUSIONS: Given 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.

Original languageEnglish
Pages (from-to)210-218
Number of pages9
JournalGaceta Medica de Mexico
Issue number3
StatePublished - 2023

Bibliographical note

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Copyright: © 2023 Permanyer.


  • Anticoagulation therapy
  • Bleeding complications
  • Complicaciones hemorrágicas
  • Complicaciones tromboembólicas
  • Deterioro valvular estructural
  • Heart valve prostheses
  • Prosthetic valve thrombosis
  • Prótesis valvulares del corazón
  • Structural valve deterioration
  • Terapia de anticoagulación
  • Thromboembolic complications
  • Trombosis valvular protésica


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