132: What are the current practices in antithrombotic therapy after bioprosthetic aortic valve replacement? A multicenter-based study

PurposeAntithrombotic therapy after bioprosthetic aortic valve replacement (AVR) is a debated issue. AVR is a frequent intervention given the high prevalence of aortic stenosis and ageing population. The absence of consensus highlights the need for an evaluation of actual clinical practices.MethodsAntithrombotic therapy was prospectively studied in 434 patients operated on for bioprosthetic AVR between January and April 2011 in 14 French centres. Patients previously treated with vitamin K antagonists (VKA) were excluded. Mean age was 75±9 years, 58% were male and 33% had coronary artery disease. Surgery was performed for aortic stenosis in 87% of cases and was combined with coronary artery bypass grafting (CABG) in 23% of patients.ResultsAfter initial heparin therapy, in-hospital antithrombotic treatment was : aspirin alone in 65% of cases; VKA alone in 9% of cases; VKA+ aspirin in 19% of cases; and neither VKA nor aspirin in 7% of cases.Factors that impacted the prescription of VKA were: coronary disease (p<0.001), associated CABG (p<0.007) and post-operative supraventricular arrhythmias (p<0.007). The strongest factor was the centre effect (p<0.0001) (Figure 1). There was no relationship between the prescription of VKA and the occurrence of in-hospital thromboembolic complications (p<0.21) or bleeding (p