Preoperative continuation of aspirin before isolated heart valve surgery and postoperative bleeding and transfusion: a single-center retrospective study

The risks and benefits of preoperative aspirin continuation in patients undergoing isolated heart valve replacement surgery are unclear. We investigated the effect of aspirin continuation on the risk of bleeding and transfusion in these patients. In this single center, retrospective study, among 474...

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Bibliographic Details
Published in:	Acta chirurgica belgica Vol. 124; no. 4; pp. 1 - 280
Main Authors:	Houben, Alan M, Crepy, Margaux, Senard, Marc, Bonhomme, Vincent, Tchana-Sato, Vincent, Hans, Gregory
Format:	Journal Article Web Resource
Language:	English
Published:	England Informa UK Limited 03-07-2024
Subjects:	Anesthesia & intensive care Anesthésie & soins intensifs Aspirin bleeding General Medicine Human health sciences Sciences de la santé humaine Surgery transfusion valve surgery Aspirin transfusion bleeding valve surgery
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Summary:	The risks and benefits of preoperative aspirin continuation in patients undergoing isolated heart valve replacement surgery are unclear. We investigated the effect of aspirin continuation on the risk of bleeding and transfusion in these patients. In this single center, retrospective study, among 474 adult patients who underwent isolated heart valve surgery between April 2013 and June 2018, 269 continued aspirin within 5 days before surgery (aspirin group) and 205 patients did not take or stopped aspirin no later than 5 days before surgery (non-aspirin group). The chi-square test, the Mann-Whitney -test, and the Student's -test were used to compare data between the groups. Univariate and Multivariate logistic regressions were used to assess crude and adjusted relationships between outcome and exposure. The primary outcome, red blood cell (RBC) transfusion, occurred in 59 patients (22%) of the aspirin group and in 24 patients (12%) of the non-aspirin group ( = 0.004). After adjustment for confounding factors, continuation of aspirin was no longer associated with RBC transfusion (aOR1.8;95%CI,0.98-3.2; = 0.06). The amount of allogenic blood products, the incidence of surgical re-exploration for bleeding, the volume of re-transfused cell-saved blood, and the cumulative chest tube drainage during the first 24 postoperative hours were similar between groups. Preoperative continuation of aspirin in patients undergoing isolated heart valve surgery is neither associated with a higher incidence of RBC transfusion, nor with larger perioperative blood loss, or more frequent surgical revision for bleeding. Clinicaltrials.gov (NCT05151796).
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 scopus-id:2-s2.0-85180826440
ISSN:	0001-5458 2577-0160
DOI:	10.1080/00015458.2023.2298097