Abstract
In various conditions of rheumatic heart diseases (RHD), as we reported previously, decrease of Antithrombin-III (AT-III) was observed, and it was supposed to be a result of hypercoagulable state in these conditions. In this study AT-III and other hemostatic parameters were examined before and after surgical treatments of 110 RHD patients to know their behaviours. And effects of Warfarin to them were also studied.
Although sites of valvular replacements had differences in AT-III and Plasminogen (Plg.) values before operations, their changes after operations seemed to be similar. Their mean values were significantly higher at 1 month after operations than pre-operative values, but they seemed to be decreased again at 2 months. At 1 month after operation, besides AT-III and Plg., inflammatory parameters remained still higher in responce to surgical procedures. Platelet count was also increased at 1 month, but they seemed to be still slightly higher even at 2 month.
Patients with open mitral commissurotomies without Warfarin therapies showed no difference in AT-III values before and after operations. But with postoperative Warfarin therapies, 62.0% of the patients showed increases in AT-III at 1 month after operations. And statistics showed use of Warfarin was related with AT-III behaviour both 1 and 2 months after operation.
The present study showed that post-operative RHD patients might be still in hypercoagulable states and Warfarin might be beneficial in view of laboratory hemostatic findings.
