TY - JOUR AU - Zhang, Lin AU - Jiang, Shengli AU - Ren, Chonglei AU - Gao, Changqing PY - 2015/04/06 Y2 - 2024/03/29 TI - Is Long-term Warfarin Therapy Necessary in Chinese Patients with Atrial Fibrillation after Bioprosthetic Mitral Valve Replacement and Left Atrial Appendage Obliteration? JF - The Heart Surgery Forum JA - HSF VL - 18 IS - 1 SE - DO - 10.1532/hsf.1219 UR - https://journal.hsforum.com/index.php/HSF/article/view/1219 SP - E011-E016 AB - <strong>Background:</strong> Long-term warfarin therapy has been used to decrease thromboembolic events in patients with atrial fibrillation (AF) following bioprosthetic mitral valve replacement (BMVR) and left atrial appendage obliteration (LAAO). A retrospective study was conducted to investigate the efficacy of long-term warfarin or aspirin therapy in patients with AF after BMVR and LAAO. <br /><strong>Methods:</strong> A total of 215 patients with persistent AF were given anticoagulation therapy with warfarin for the first <br />3 months after BMVR and LAAO, continuing warfarin or aspirin therapy according to the surgeon’s preference. A yearly follow-up with patients was performed by telephone or mail for postoperative condition, cerebrovascular, and bleeding events. <br /><strong>Results:</strong> Seven patients died in the first 3 months after surgery, including 6 patients from heart failure and 1 patient from sudden death. The remaining 208 patients were divided into two groups: warfarin group (n = 84 patients) and aspirin group (n = 124). The patients in the warfarin group were older than those in the aspirin group and had a lower postoperative left ventricular ejection fraction. Other baseline and operative characteristics were similar. The two groups had similar incidence of thromboembolic events (9.5% versus 8.9%, P = .873) and bleeding events(7.1% versus 3.2%, <br />P = .207). Each group had one intracranial hemorrhage. Eleven patients expired within three months after surgery, 4(4.8%) in the warfarin group and 10(8.1%)in the aspirin group (P = .411 by Fisher exact test). Cumulative survival was not significantly different in the two groups by Kaplan-Meier analysis (P = .55, log-rank test). <br /><strong>Conclusion:</strong> At the current time in China, long-term warfarin or aspirin therapy may have no significantly different impact on long-term prognosis after 3 months anticoagulation with warfarin in patients with AF undergoing BMVR and LAAO. ER -