Dental and Oral Surgical Treatment in the Management of Prosthetic Heart Valves Patients
The aim of this work was to show the specific stomatological approach and treatment of patients with prosthetic heart valves (PHV) which belong in the group of patients with high risk from several aspects. The research included 80 individuals. The preparation included: laboratory blood examination 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. Medical risk assessment of these patients consists of three segments: safe dental and oral surgery treatment with stabile cardiac function, existing risk of potential development for infective endocarditis, and the potential for altered hemostasis in patients prescribed anticoagulant medications. Key words: tooth extraction, oral surgery, prosthetic heart valves, oral anticoagulants, infective endocarditis, tranexamic acid, antibotherapy, bacteremia.