THE MANAGEMENT OF ANTICOAGULATION IN PATIENTS WITH PROSTHETIC HEART-VALVES UNDERGOING NONCARDIAC OPERATIONS

Prosthetic valve thrombogenicity and bleeding complications associated with life-long anticoagulation are constant potential causes of morbi dity and mortality following prosthetic valve implantation. The confli ct between over- and under-anticoagulation is even more of a problem w hen other surgical interventions are required. Very few clinical trial s have addressed this issue. We propose some guidelines based on the c oncept of risk-adjusted intensity of anticoagulation but stress the ne ed for caution with intepretation of these recommendations.