Kazi Shariful Islam
National institute of cardiovascular Diseases, BangladeshTitle: Is Bridging Anticoagulation with Heparin after Valve Replacement Surgery Mandatory?- A Prospective Observational Study in a Centre of Bangladesh
Abstract
Background: This
is a prospective observational single center study to determine whether
bridging anticoagulation with heparin along with warfarin is mandatory in a
heterogenous group of patients undergoing valve replacement surgery either
single or multiple valve (with mechanical or tissue valve) in the
post-operative period.
Methods: Perioperative data were collected in 41
patients undergoing multiple valve replacement at this center from July/2019 to
September/2019 irrespective of age, sex, number and type of valve replaced. No
bridging anticoagulation was given in preoperative and postoperative period in
these patients. They were prospectively observed for the incidence of any
thromboembolic end bleeding events with daily measurement of International Normalized
Ratio (INR) till INR reached at therapeutic level for oral anticoagulant
warfarin and complications of warfarin therapy.
Results: All the patient
suffered from chronic Rheumatic heart disease. Single valve disease was in
70.73% and multiple valve disease was in 29.27% cases. Two patients had left
atrial thrombus, seven patient (14.63%) had preoperative atrial fibrillation
(AF). Postoperative new onset AF was present in 10 (24.39%) cases. No
thromboembolism occurred in these patients and warfarin over anticoagulation
was found in 1/41 patient.
Conclusion:
Patients undergoing valve replacement surgery without concomitant postoperative
bridging anticoagulation with heparin do
not suffer from any thromboembolic and bleeding complications even at lower
level of INR. This study also shows that single and multiple valv (both mechanical
and tissue valve) have the same in hospital outcome in relation to
thromboembolism and bleeding complications.
Biography
Kazi
Shariful Islam is Bangladeshi. By
birth, he graduated from Dhaka medical college, Bangladesh in 1988. He was a
Govt. employee in the National Institute of Cardiovascular Diseases(NICVD),
Dhaka. Bangladesh, under the Ministry of Health and Family Welfare. He did his
post-graduation MS(CV&TS) degree in 2000. He also completed a thesis
work. He is an adult cardiac surgeon with some interest in pediatric
cardiac surgery as well. He was a unit chief in the department of cardiac
surgery at NICVD, Dhaka during his job time. He has around 13 publications
mostly in National journals and one in international journals..He is interested
in research-oriented work. He is now attached to private Hospitals and doing his practice.