MARKERS OF COAGULATION AND PLATELET ACTIVATION DURING PERCUTANEOUS MITRAL VALVULOPLASTY

The effect of percutaneous mitral valvuloplasty (PMV) on markers of co agulation and platelet activation was investigated to assess whether c oagulation or platelet activation take place during and after PMV even under conditions of full heparinization. Before PMV, all the hemostat ic parameters studied were in the normal range compared with those of a control group. Two hours after PMV the levels of prothrombin fragmen t F1 and 2 (F1 + 2) (1.6 +/- 0.6 nmol/l versus 0.8 +/- 0.3 nmol/l, P < 0.005), plasma thrombin-antithrombin III (TAT) complexes (5.4 +/- 3.2 ng/ml versus 2.2 +/- 0.9 ng/ml) and beta-thromboglobulin (119 +/- 70 ng/ml versus 42.2 +/- 41 ng/ml) had increased significantly compared w ith those measured at basal conditions. Activated partial thromboplast in time was significantly prolonged (152 +/- 40 s versus 21 +/- 5 s), reflecting full heparinization. Levels of fibrinogen, F1 + 2, TAT and beta-thromboglobulin remained increased 72 h after PMV. We conclude th at patients with severe, symptomatic mitral stenosis undergoing PMV ne ed a more specific antithrombotic therapy or a more prolonged and perh aps less intensive heparinization. (C) 1998 Lippincott Williams & Wilk ins.