CODE: 18 - Standards of perioperative care for patients with artificial heart valve prosthesis qualified to urological procedure
Article published in Urologia Polska 2006/59/Suplement 1.
Przemysław Trzeciak 1, Marian Zembala 2, Jerzy Foremny 2, Lech Poloński 1
- 1 III Katedra i Oddział Kliniczny Kardiologii ¦AM, ¦l±skie Centrum Chorób Serca w Zabrzu
2 Katedra i Oddział Kliniczny Kardiochirurgii i Transplantologii ¦AM, ¦l±skie Centrum Chorób Serca w Zabrzu
- The most common complications among patients with artificial heart valve prosthesis are: thromboembolic and haemorrhagic complications due to anticoagulant therapy; infective endocarditis due to artificial heart valve prosthesis. The incidence of thromboembolic, haemorrhagic complications, and infective endocarditis in patients with artificial heart valve prosthesis is underestimated. Horskotte et al. noted that during 10 years of follow-up period haemorrhagic and thromboembolic complications were observed in 48.5% and 33% patients, respectively. Patients with artificial heart valve prosthesis need a proper care in perioperative period due to anticoagulant therapy. It decreases risk of thromboembolic and haemorrhagic complications. Cooperation of cardiologist, cardiac surgeon, and urologist is necessary to decrease the risk of infective endocarditis in patients with artificial heart valve prosthesis and other heart valve disease. Some of urological procedures need a specified antibiotic prophylaxis in perioperative period. Every patient after heart valve replacement in Silesian Center of Heart Disease obtains Identity Card of the Patient with Artificial Heart Valve. It contains information about side-effects, complications of anticoagulant therapy. It contains information about interaction of oral anticoagulant with drugs and food. Identity Card has detailed instruction of safe cessation of oral anticoagulant therapy before surgery. It contains standards of European Society of Cardiology about antibiotic prophylaxis before urological diagnostic and therapeutic procedure. It has detailed instructions about kind and dose of antibiotic.