Contemporary dental and oral surgical concept in the treatment of prosthetic heart valves patients

Dimova, Cena and Kovacevska, Ivona and Georgiev, Zlatko (2009) Contemporary dental and oral surgical concept in the treatment of prosthetic heart valves patients. Journal of Dentistry Apolonia, 11 (21). pp. 57-70. ISSN 1409-8768(Print), 1857-6087(Online)


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The individuals with implanted prosthetic heart valves (PHV) belong in the group of patients with high risk from several aspects. Medical risk assessment of these patients consists of three segments: cardiac function and safe dental and oral surgery treatment, existing risk of potential development and prevention from infective endocarditis, and the potential for altered hemostasis in patients prescribed anticoagulant medications. The aim of this work was to show the specific stomatological approach and treatment of patients with PHV. The research included 20 individuals. The preparation included: laboratory blood examination (number of blood platelets, hematocrit, blood test with leukocyte formula, the value of fibrinogen, CRP, as well as prothrombin time, INR, glycaemia, urea and bilirubin), and antibiotic prophylaxis (according to the protocol of the American Heart Association – AHA). Detail anamnesis, inspection and X ray examination have been provided on the entire examined person. Twenty four oral surgery interventions have been made. The oral anticoagulants have been interrupted before the interventions and low molecular weight heparin (LMWH) has been included, before and after the interventions. Definitive local homeostasis has been accomplished with the use of 5% tranexamic acid as mouthwash solution. During the first, second and seventh day of the intervention, the patients have been followed through from aspect of possible development of local and general complications after the intervention and in one month period concerning the general health condition. Complications such as prolonged bleeding, development of infective endocarditis and thromboembolism episode have not been established. Selective approach and preparation as well as interdisciplinary cooperation with the cardiologists are the base for safe and quality oral surgery treatment of prosthetic heart valves patients. Key words: tooth extraction, oral surgery, prosthetic heart valves, oral anticoagulants, infective endocarditis, tranexamic acid, antibotherapy, bacteriemia.

Item Type: Article
Subjects: Medical and Health Sciences > Basic medicine
Medical and Health Sciences > Clinical medicine
Medical and Health Sciences > Health sciences
Medical and Health Sciences > Other medical sciences
Divisions: Faculty of Medical Science
Depositing User: Cena Dimova
Date Deposited: 01 Apr 2013 09:59
Last Modified: 19 Feb 2014 08:48

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