Background: The use of low molecular weight heparin for early anticoagulation after mechanical aortic valve replacement is still a matter of debate even more that the early postoperative phase is associated with maxim...Background: The use of low molecular weight heparin for early anticoagulation after mechanical aortic valve replacement is still a matter of debate even more that the early postoperative phase is associated with maximum of thrombo-embolic and bleeding risks. The objective of this study is to verify the efficacy and the safety of low molecular weight heparin for the early anticoagulation after mechanical aortic valve replacement. Methods and Results: It is a prospective study conducted over 6 months and interested 40 consecutive patients (32 male and 8 female) with a mean age 53.83 ± 16.93 years (19-75 years) who underwent a mechanical aortic valve replacement and received enoxaparin as bridging therapy between continuous unfractionated heparin and fully effective vitamin K antagonist therapy. There was no in-hospital death and no in-hospital thromboembolic events. We report 2 major bleeding events (5%). Conclusion: The use of low molecular weight heparin should be an alternative to explore for early anticoagulation after valve heart surgery and the results of our study must be verified by large randomized studies before drawing any hasty conclusions.展开更多
Spontaneous coronary artery dissection (SCAD) should be strongly suspected in young women with few or no traditional risk factors for atherosclerosis. Prompt diagnosis and treatment improve survival. The most appropri...Spontaneous coronary artery dissection (SCAD) should be strongly suspected in young women with few or no traditional risk factors for atherosclerosis. Prompt diagnosis and treatment improve survival. The most appropriate strategy for managing SCAD is still controversial due to the heterogeneity of this population. We describe a case of spontaneous left main coronary artery (LMCA) dissection in a young women that was successfully managed by percutaneous coronary intervention (PCI) followed by coronary artery bypass grafting (CABG), this case illustrates the utility of coronary computed tomography (CT) and magnetic resonance imagery (MRI) in assessing complex coronary dissection, thereby helping to determine the best timing for surgery.展开更多
文摘Background: The use of low molecular weight heparin for early anticoagulation after mechanical aortic valve replacement is still a matter of debate even more that the early postoperative phase is associated with maximum of thrombo-embolic and bleeding risks. The objective of this study is to verify the efficacy and the safety of low molecular weight heparin for the early anticoagulation after mechanical aortic valve replacement. Methods and Results: It is a prospective study conducted over 6 months and interested 40 consecutive patients (32 male and 8 female) with a mean age 53.83 ± 16.93 years (19-75 years) who underwent a mechanical aortic valve replacement and received enoxaparin as bridging therapy between continuous unfractionated heparin and fully effective vitamin K antagonist therapy. There was no in-hospital death and no in-hospital thromboembolic events. We report 2 major bleeding events (5%). Conclusion: The use of low molecular weight heparin should be an alternative to explore for early anticoagulation after valve heart surgery and the results of our study must be verified by large randomized studies before drawing any hasty conclusions.
文摘Spontaneous coronary artery dissection (SCAD) should be strongly suspected in young women with few or no traditional risk factors for atherosclerosis. Prompt diagnosis and treatment improve survival. The most appropriate strategy for managing SCAD is still controversial due to the heterogeneity of this population. We describe a case of spontaneous left main coronary artery (LMCA) dissection in a young women that was successfully managed by percutaneous coronary intervention (PCI) followed by coronary artery bypass grafting (CABG), this case illustrates the utility of coronary computed tomography (CT) and magnetic resonance imagery (MRI) in assessing complex coronary dissection, thereby helping to determine the best timing for surgery.