ICVTS on-line discussion A

boembolic events, seven were TIAs without major sequelae, two patients had permanent deficit and one patient died. Eighty-eight patients remained on long-term anticoagula-tion because of AF. There were six reported haemorrhagic complications, for an actuarial rate of 95.6"1.97% patients free of anticoagulation related haemorrhage at 15 years for the total series and 91% for the 88 patients receiving anticoagulation. 7. Clinical bottom line The current European Society of Cardiology guidelines support the use of warfarin for 3 months post-mitral repair, citing an absence of studies supporting the safety of omitting warfarin. They acknowledge that this is based on expert consensus and that many surgeons do not follow this guideline. The longest follow-up studies of patients post-mitral repair report excellent results using short term warfarin, and they also show that a third of patients discharged in sinus rhythm will have an episode of atrial fibrillation shortly after. In addition, the highest risk of thromboembolism occurs in the early months post surgery. Therefore, until studies demonstrate the safety of omitting warfarin for patients undergoing mitral valve repair 3 months of anticoagulation should remain the standard of care. for the management of patients with valvular heart disease. Executive summary. A report of the American College of CardiologyyAmerican Heart Association task force on practice guidelines (Committee on management of patients with valvular heart disease). Guidelines for the management of patients with valvular heart disease: executive summary. A report of the American College of CardiologyyAmerican Heart Association task force on practice guidelines (Committee on management of patients with valvular heart disease). Pauker SG. Antithrombotic therapy in valvular heart disease – native and prosthetic. The seventh ACCP conference on antithrombotic and thrombolytic therapy. An audit of anticoagulation practice among UK cardiothoracic consultant surgeons following valve replacementyrepair. A. Very long-term results (more than 20 years) of valve repair with Carpentier's techniques in nonrheumatic mitral valve insufficiency. Prevention of thromboem-bolism with ticlopidine shortly after valve repair or replacement with a bioprosthesis. Long-term results of mitral valve reconstruction with Carpentier techniques in 148 patients with mitral insufficiency. cardiac rehabilitation and exercise physiology, European Society of Cardiology. Recommendations for the management of patients after heart valve surgery. An audit of anticoagulation practice among UK cardiothoracic consultant surgeons following valve replacementy repair. eComment: The authors deal with a very interesting topic of oral anticoagulation after mitral valve repair w1x. Although most of us would agree to use warfarin in patients in …