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===Excessive Anticoagulation and Serious Bleeding With Prosthetic Valves | ===Excessive Anticoagulation and Serious Bleeding With Prosthetic Valves<ref name="pmid24603192">{{cite journal |vauthors=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA, O'Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM, Thomas JD |title=2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines |journal=J. Am. Coll. Cardiol. |volume=63 |issue=22 |pages=2438–88 |year=2014 |pmid=24603192 |doi=10.1016/j.jacc.2014.02.537 |url=}}</ref>=== | ||
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Revision as of 16:41, 27 October 2016
Excessive Anticoagulation and Serious Bleeding With Prosthetic Valves[1]
| Class IIa |
| "1. Administration of fresh frozen plasma or prothrombin complex concentrate is reasonable in patients with mechanical valves and uncontrollable bleeding who require reversal of anticoagulation (Level of Evidence: B)" |
Prosthetic Valve Thrombosis
Diagnosis and Follow-up
| Class I |
| "1. TTE is indicated in patients with suspected prosthetic valve thrombosis to assess hemodynamic severity and follow resolution of valve dysfunction.(Level of Evidence: B)" |
| "2. TEE is indicated in patients with suspected prosthetic valve thrombosis to assess thrombus size and valve motion(Level of Evidence: B)" |
| Class IIa |
| "1. Fluoroscopy or CT is reasonable in patients with suspected valve thrombosis to assess valve motion. (Level of Evidence: C)" |
Medical Therapy
| Class IIa |
| "1. Fibrinolytic therapy is reasonable for patients with a throm- bosed left-sided prosthetic heart valve, recent onset (<14 days) of NYHA class I to II symptoms, and a small thrombus (<0.8 cm2) (Level of Evidence: B)" |
| "2. Fibrinolytic therapy is reasonable for thrombosed right-sided prosthetic heart valves (Level of Evidence: B)" |
Intervention
| Class I |
| "1. Emergency surgery is recommended for patients with a throm- bosed left-sided prosthetic heart valve with NYHA class III to IV symptoms(Level of Evidence: B)" |
| Class IIa |
| "1. Emergencysurgeryisreasonableforpatientswithathrombosed left-sided prosthetic heart valve with a mobile or large thrombus (>0.8 cm2) (Level of Evidence: C)" |
- ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA, O'Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM, Thomas JD (2014). "2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J. Am. Coll. Cardiol. 63 (22): 2438–88. doi:10.1016/j.jacc.2014.02.537. PMID 24603192.