dicumarol and Postoperative-Complications

Arthroscopy of the knee has always been associated with a low risk of complications, including thromboembolism. Therefore, few studies have been concerned with the matter. We present two case reports and a review of the available literature concerning thromboembolic complications after arthroscopy.

Topics: Adult; Arthroscopy; Dicumarol; Drug Therapy, Combination; Heparin; Humans; Knee Injuries; Male; Menisci, Tibial; Middle Aged; Postoperative Complications; Thrombophlebitis; Tibial Meniscus Injuries

Topics: Anticoagulants; Bandages; Blood Flow Velocity; Dextrans; Dicumarol; Economics, Medical; Electric Stimulation; Female; Fibrinogen; Fibrinolysis; Heparin; Humans; Locomotion; Male; Middle Aged; Platelet Aggregation; Postoperative Complications; Pressure; Thrombophlebitis

Eighty-eight patients underwent a classical reversed saphenous vein graft for femoro-popliteal occlusive disease and were enrolled in a controlled clinical trial. During the second postoperative week the patients were allocated randomly into one of two groups: group I consisted of 42 patients who received dicumarol and group II (46 patients) served as a control group without any anticoagulant treatment. The mean follow-up time was 24 months. After 12 months the cumulative patency rate was 82%, after 18 months 76% and after 24 months 76%; for patients receiving dicumarol treatment the respective figures were 92%, 86% and 86% and for those with no treatment 70%, 67% and 67%, the difference being significant. When the bypass operation was performed for limb salvage (clinical stages III and IV) the overall results were worse (12 months: 72%, 18 months: 68%, 24 months: 68%) than in stages II, II-III (12 months: 90%, 18 months: 85%, 24 months: 85%). In limb salvage surgery the positive effects of anticoagulant treatment were significant (with treatment: 12 months 87%, 18 months 86%, 24 months 86%; without treatment: 12 months 58%, 18 months 54%, 24 months 54%).

Topics: Aged; Clinical Trials as Topic; Dicumarol; Femoral Artery; Follow-Up Studies; Graft Occlusion, Vascular; Humans; Ischemia; Leg; Popliteal Artery; Postoperative Complications; Saphenous Vein; Thrombophlebitis

Topics: Adult; Aged; Clinical Trials as Topic; Dicumarol; Electric Stimulation; Female; Hemodynamics; Heparin; Humans; Leg; Male; Methods; Middle Aged; Postoperative Complications; Posture; Pulmonary Embolism; Statistics as Topic; Thrombophlebitis; Vena Cava, Inferior

Aortobronchial fistula is a rare but serious cause of hemoptysis. It can develop from an aneurysm of the descending thoracic aorta in the context of infections or it may appear as a sequel of surgical repair of congenital heart defects. Presenting symptoms include mild bronchial hemorrhages and recurrent chest pain, culminating in a normally fatal massive hemorrhage. Diagnosis by imaging is not always conclusive and clinical suspicion based on medical history is essential. Surgical placement of an endovascular stent graft is the treatment of choice. Post-surgical prognosis is good although there is a risk of recurrence in the case of superinfection.

Topics: Aneurysm, False; Anticoagulants; Aorta, Thoracic; Aortic Coarctation; Aortic Diseases; Aortography; Blood Vessel Prosthesis Implantation; Bronchial Fistula; Combined Modality Therapy; Dicumarol; Embolization, Therapeutic; Fistula; Hemoptysis; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Postoperative Complications; Recurrence; Venous Thrombosis

A 19-year-old man with congenital cyanotic heart disease experienced subarachnoid bleeding from a ruptured cerebral aneurysm. Immediate rebleeding with disordered hemostasis caused by prophylactic anticoagulation treatment was the cause of death. Medical progress in repairing congenital heart disease or attenuating its effects has increased the life expectancy of such patients. Anesthesiologists who are not specialized in this area may find themselves assuming responsibility for these patients during non-cardiac surgery of greater or lesser extension.

Topics: Adult; Aneurysm, Ruptured; Anticoagulants; Cyanosis; Dicumarol; Encephalocele; Fatal Outcome; Heart Septal Defects, Ventricular; Humans; Intracranial Aneurysm; Intracranial Hypertension; Intraoperative Complications; Male; Postoperative Complications; Prothrombin; Pulmonary Atresia; Recurrence; Subarachnoid Hemorrhage; Thromboembolism

Budd-Chiari syndrome (BCS) with hepatic vein occlusion is a rare disorder that can effectively be treated in advanced stages with orthotopic liver transplantation. We report on 16 patients who received 18 liver grafts and were followed up for at least 2 years. In 7 patients a hematological disorder was confirmed by bone marrow biopsy. One patient died after 4 months due to cytomegalovirus pneumonia; another patient died after 2 years due to progressive liver failure after portal vein thrombosis. The actuarial 5-year survival rate is 87.5% compared to 85.3% in all other 710 orthotopic liver transplantations performed from September 1988 to December 1995 at our institution. Anticoagulation consisted of intravenous heparin and overlapping continuation with dicoumarin. Three patients received hydroxyurea for thrombocytosis, one patient for 1 week only early after the transplantation. Two postoperative abdominal hemorrhages required laparotomy. Two patients had to be retransplanted, one for thrombosis of the hepatic artery and portal vein after discontinuation of dicoumarin due to GI bleeding and one for hepatic vein thrombosis after insufficient dicoumarin intake. Terminal BCS represents a good indication for orthotopic liver transplantation; however, life-long, closely monitored anticoagulation is essential.

Topics: Adolescent; Adult; Anticoagulants; Budd-Chiari Syndrome; Cause of Death; Dicumarol; Female; Follow-Up Studies; Heparin; Humans; Liver Transplantation; Male; Middle Aged; Postoperative Care; Postoperative Complications; Reoperation; Survival Rate

Topics: Aortic Valve; Blood Coagulation Disorders; Dicumarol; Follow-Up Studies; Heart Valve Prosthesis; Heparin; Humans; Mitral Valve; Postoperative Complications; Tricuspid Valve

Topics: Adolescent; Aortic Valve; Bioprosthesis; Child; Dicumarol; Female; Follow-Up Studies; Heart Valve Diseases; Heart Valve Prosthesis; Hemodynamics; Hemorrhage; Humans; Male; Mitral Valve; Postoperative Complications; Prosthesis Design; Prosthesis Failure; Thromboembolism

Topics: Adult; Atrial Fibrillation; Bioprosthesis; Calcinosis; Cardiac Output, Low; Dicumarol; Female; Follow-Up Studies; Heart Valve Diseases; Heart Valve Prosthesis; Humans; Male; Middle Aged; Mitral Valve; Postoperative Complications; Prosthesis Design; Risk; Thromboembolism; Thrombosis

Twenty-four children (ages 1 to 18 years, mean 12.2 years) underwent 27 operations for aortic, mitral, or combined aortic and mitral valve replacement. There was 1 operative death. Of the 23 operative survivors (12 aortic, 8 mitral, 3 combined valve replacement), only 5 were given warfarin for long-term anticoagulation. The remaining 18 (10 aortic, 8 mitral valve replacement) were given aspirin (plus dipyridamole in 5). Twelve of the 18 had at least one mechanical valve (11 Björk-Shiley and Beall valves; 1 Björk-Shiley valve was replaced with a Beall disc valve as the child grew). These 18 patients were followed for 1 to 59 months (mean, 20.4 months). There was no thrombotic, embolic, or bleeding complications. There were 2 late deaths (one cardiac). Review of the available literature indicates that in children with prosthetic cardiac valves, aspirin (with or without dipyridamole) provides adequate protection against thromboemboli and avoids the hemorrhagic complications associated with warfarin.

Topics: Adolescent; Anticoagulants; Aortic Valve; Aspirin; Bioprosthesis; Child; Child, Preschool; Dicumarol; Dipyridamole; Drug Therapy, Combination; Heart Valve Diseases; Heart Valve Prosthesis; Humans; Infant; Mitral Valve; Postoperative Complications; Retrospective Studies; Thromboembolism; Warfarin

Quinton-Scribner shunts have been used as a reliable access to the blood-stream in 56 patients treated with intermittent hemodialysis in the years 1965-71. The mean age of 29 men and 27 women was 39 years. Two hundred and thirty-two cannulae showed a mean survival time of 11.2 months for 103 arterial cannulae and 9.0 months for 129 venous cannulae. 700 shunt clotting episodes occurred during 1157 patient months, i.e. 0.6 clotting episode/month. In 350 episodes where saline flushing could not remove the clot, the effect of treatment with streptokinase was considered evident in 79.7%. Shunt cannula infection was a common complication while aseptic cutaneous necrosis and bleeding from the cannulated vessel were seen less frequently. Both severe and less harmful bleeding episodes were seen as a complication of dicumarol therapy. The number of complications to streptokinase treatments was low. The advantages and disadvantages of the Quinton-Scribner shunt for hemodialysis are discussed.

Topics: Adolescent; Adult; Arteriovenous Shunt, Surgical; Blood Coagulation; Child; Dicumarol; Female; Fever; Hemorrhage; Humans; Male; Middle Aged; Osteonecrosis; Postoperative Complications; Renal Dialysis; Sodium Chloride; Staphylococcal Infections; Streptokinase; Surgical Wound Infection

A series of 108 arterial embolectomies in 91 patients performed during 1960-64 and 1970-74 is presented. The Fogarty catheter was introduced in our clinic between these periods. Early mortality was 56 and 29%, respectively. Limb salvage rate according to our definition was 38 and 53%, respectively. We found a significantly higher mortality when embolies were located proximal to the profunda femoral artery compared to more distally located embolies. Amputation frequency was 4% after embolectomies performed within 12 hours, but 27% with longer duration of symptoms. Limb salvage rate was significantly higher in patients treated with anticoagulation. In conclusion it is stressed that local surgical therapy should be combined with adequate measures against cardiac failure and other systemic complications. This therapeutic principle is particularly important in cases with proximal embolies.

Topics: Aged; Amputation, Surgical; Arm; Dicumarol; Embolism; Female; Heart Failure; Heparin; Humans; Leg; Male; Middle Aged; Myocardial Infarction; Postoperative Complications; Pulmonary Embolism; Time Factors

Topics: Aged; Anticoagulants; Dicumarol; Heparin; Humans; Ligation; Postoperative Complications; Pulmonary Embolism; Recurrence; Vena Cava, Inferior; Warfarin

Topics: Adult; Aged; Angiography; Arterial Occlusive Diseases; Catheterization; Dicumarol; Female; Femoral Artery; Follow-Up Studies; Germany, West; Heparin; Humans; Male; Middle Aged; Popliteal Artery; Postoperative Complications; Streptokinase

Dicumarol anticoagulation poved very effective in the prevention of thromboembolic complications after aortic valve replacement with the Björk-Shiley tilting disc valve. We have, however, encountered six late deaths because of massive cerebral hemorrhage, which represent 3% of the patients who were maintained on dicumarol medication at that time. This unacceptable mortality prompted us to introduce two programmes, one without anticoagulation and another one with dipyridamole-acetylsalicylic acid. Furthermore, dicumarol was terminated in patients with haemorrhagic episodes, instable anticoagulation, pregnancy, and in those reguiring surgery. The results were disappointing, however, and the majority of the patients involved were therefore put on dicumarol medication. Eleven of the 64 consecutive patients taking dipyridamole - acetylsalicylic acid had thrombo-embolic episodes during a mean follow-up period of 9 months...

Topics: Adult; Aortic Valve; Aspirin; Cerebral Hemorrhage; Dicumarol; Dipyridamole; Drug Therapy, Combination; Female; Follow-Up Studies; Heart Valve Prosthesis; Humans; Middle Aged; Postoperative Complications; Thromboembolism; Time Factors

Topics: Adult; Aged; Aortic Valve; Aortic Valve Insufficiency; Aortic Valve Stenosis; Aortography; Blood Flow Velocity; Blood Pressure; Dicumarol; Female; Follow-Up Studies; Haptoglobins; Heart Valve Prosthesis; Hemolysis; Humans; L-Lactate Dehydrogenase; Male; Middle Aged; Postoperative Complications; Prognosis; Recurrence; Thromboembolism

Topics: Adult; Aged; Anticoagulants; Anxiety; Atrophy; Brain Diseases; Dementia; Dicumarol; Fear; Female; Haloperidol; Humans; Informed Consent; Intracranial Arteriosclerosis; Male; Middle Aged; Pain, Intractable; Paranoid Disorders; Pneumoencephalography; Postoperative Complications; Prothrombin Time; Psychotherapy

Topics: Adolescent; Adult; Blood Flow Velocity; Blood Pressure; Blood Volume; Cardiac Output; Cardiac Volume; Child; Child, Preschool; Dicumarol; Exercise Test; Female; Follow-Up Studies; Heart Valve Prosthesis; Hemodynamics; Hemoglobins; Humans; Male; Middle Aged; Mitral Valve; Mitral Valve Insufficiency; Mitral Valve Stenosis; Postoperative Complications; Pulmonary Circulation; Thromboembolism

Topics: Adolescent; Adult; Aged; Dicumarol; Drug Therapy, Combination; Female; Hematoma; Hip; Hip Dislocation; Hip Joint; Humans; Joint Prosthesis; Male; Methylmethacrylates; Middle Aged; Ossification, Heterotopic; Peripheral Nervous System Diseases; Polyethylenes; Postoperative Complications; Prosthesis Design; Statistics as Topic; Surgical Wound Infection; Thrombosis

Topics: Adult; Atrial Fibrillation; Blood Coagulation; Blood Flow Velocity; Blood Pressure; Blood Volume; Cardiac Output; Dicumarol; Female; Follow-Up Studies; Heart Rate; Heart Valve Prosthesis; Humans; Male; Methods; Middle Aged; Mitral Valve; Oxygen Consumption; Postoperative Complications; Rheology

Topics: Anti-Bacterial Agents; Chloramphenicol; Dicumarol; Drug Interactions; Hemorrhage; Humans; Postoperative Complications; Surgical Procedures, Operative; Surgical Wound Infection

Topics: Aged; Dextrans; Dicumarol; Female; Heparin; Humans; Iodohippuric Acid; Leg; Male; Middle Aged; Phlebography; Postoperative Complications; Radioisotopes; Regional Blood Flow; Rheology; Serum Albumin, Radio-Iodinated; Thromboembolism; Thrombophlebitis; Time Factors; Xenon

Topics: Adult; Aged; Anticoagulants; Blood Circulation; Blood Coagulation; Dicumarol; Embolism; Endarterectomy; Female; Heparin; Humans; Male; Middle Aged; Postoperative Complications; Prognosis

Topics: Aged; Dextrans; Dicumarol; Female; Femoral Neck Fractures; Humans; Leg; Male; Phlebography; Postoperative Complications; Thrombophlebitis; Thrombosis; Veins

Topics: Aneurysm; Animals; Aortic Aneurysm; Aortography; Arteries; Arteriosclerosis; Arteriosclerosis Obliterans; Blood Coagulation; Blood Vessel Prosthesis; Dextrans; Dicumarol; Dogs; Female; Fibrinolytic Agents; Heparin; Humans; Male; Methods; Nylons; Phenindione; Plastics; Postoperative Complications; Suture Techniques; Thrombosis; Vascular Surgical Procedures; Vitamin K

Topics: Adult; Age Factors; Aged; Angiography; Blood Vessel Prosthesis; Diabetes Complications; Dicumarol; Female; Femoral Artery; Fluorocarbon Polymers; Follow-Up Studies; Heparin; Humans; Iliac Artery; Intermittent Claudication; Ischemia; Leg; Male; Methods; Middle Aged; Popliteal Artery; Postoperative Complications; Sex Factors; Thrombosis; Transplantation, Autologous; Transplantation, Homologous; Vascular Diseases; Veins; Warfarin

Topics: Adult; Age Factors; Aged; Aprotinin; Dicumarol; Female; Hemorrhage; Humans; Male; Middle Aged; Peritonitis; Postoperative Complications; Pulmonary Embolism; Sex Factors; Wound Healing

Topics: Adult; Age Factors; Aged; Aminocaproates; Anticoagulants; Dicumarol; Female; Heparin; Humans; Male; Middle Aged; Obesity; Postoperative Care; Postoperative Complications; Preoperative Care; Pulmonary Embolism; Surgical Procedures, Operative

Topics: Dicumarol; Humans; Phlebography; Postoperative Complications; Thrombophlebitis

Topics: Arteriosclerosis; Arteriosclerosis Obliterans; Chronic Disease; Dicumarol; Heparin; Humans; Postoperative Complications; Thrombosis

Topics: Abdomen; Coumarins; Dicumarol; Humans; Postoperative Complications; Thromboembolism; Warfarin

Topics: Dicumarol; Humans; Postoperative Care; Postoperative Complications; Pulmonary Embolism; Thrombophlebitis; Warfarin

Topics: Aged; Dicumarol; Female; Heparin; Humans; Male; Postoperative Complications; Vascular Diseases

Topics: Acenocoumarol; Anticoagulants; Dicumarol; Drug Therapy; Heparin; Phenindione; Postoperative Complications; Preventive Medicine; Pulmonary Embolism; Thrombophlebitis; Toxicology; Venous Thrombosis; Vitamin K 1; Warfarin

Topics: Dicumarol; Enzyme Inhibitors; Heparin; Phenindione; Postoperative Complications; Prothrombin; Thrombophlebitis; Warfarin

Topics: Adolescent; Angiocardiography; Anticoagulants; Aorta; Aorta, Thoracic; Cardiac Catheterization; Cardiac Surgical Procedures; Child; Dicumarol; Heart Auscultation; Humans; Infant; Infant, Newborn; Intracranial Embolism; Intracranial Embolism and Thrombosis; Postoperative Care; Postoperative Complications; Preoperative Care; Pulmonary Artery; Subclavian Artery; Tetralogy of Fallot; Thoracic Surgery

Topics: Anticoagulants; Coronary Disease; Dicumarol; Embolism; Ethyl Biscoumacetate; Hemorrhage; Humans; Postoperative Complications; Prothrombin Time; Thrombophlebitis; Toxicology; Warfarin

Topics: Anti-Bacterial Agents; Cecum; Dicumarol; Diverticulitis; Heparin; Humans; Postoperative Complications; Pulmonary Embolism; Shock; Surgical Procedures, Operative

Topics: Adolescent; Angiography; Aorta; Aorta, Abdominal; Aortic Coarctation; Blood Circulation; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Collateral Circulation; Dicumarol; Humans; Hypertension; Nephrectomy; Pathology; Postoperative Complications; Prognosis; Renal Artery; Renal Artery Obstruction; Thrombosis; Toxicology

Topics: Dicumarol; Heparin; Humans; Phlebitis; Postoperative Complications; Preoperative Care; Pulmonary Embolism; Vascular Surgical Procedures; Vena Cava, Inferior

Topics: Anticoagulants; Dicumarol; Humans; Postoperative Complications; Pulmonary Embolism; Surgical Procedures, Operative; Thromboembolism

Topics: Anticoagulants; Coumarins; Dicumarol; Embolism; Humans; Phenprocoumon; Postoperative Complications; Surgical Procedures, Operative; Thromboembolism

Topics: Anticoagulants; Coumarins; Dicumarol; Humans; Postoperative Care; Postoperative Complications; Private Practice; Thromboembolism

Topics: Dicumarol; Embolism; General Surgery; Humans; Postoperative Complications; Thrombosis