Heparin endocarditis prophylaxis

For premedication aspirin 300 mg twice a day 48 hours prior to the procedure and a loading dose of clopidogrel 300 mg (or ticlopidine 250 mg) is recommended. Endocarditis prophylaxis with a first generation cephalosporin (e.g., cefuroxime, 1, 5 g, i.v.) should be administered before and after intervention. After transseptal puncture, 10,000 units of heparin are administered. An activated clotting time of 200-300 seconds is desirable. 

Intravenous antibiotics are given before and after the procedure. Five thousand to ten thousand units of heparin should be administered after transseptal puncture. Aspirin (100-300 mg/day, p.o.) and clopidogrel (75 mg/day, p.o.) is prescribed for the following six months as well as endocarditis prophylaxis. A TEE is performed at six months. If the LAA is completely occluded, no further anticoagulation is required. 

With annuloplasty procedures heparin and endocarditis prophylaxis should be administered before the procedures. When the edge-to-edge technique is performed, heparin should not be administered until the transseptal puncture has been performed. Regular follow-up examination, anticoagulation, and endocarditis prophylaxis are recommended after mitral repair procedures. 

Before intervention heparin is administered (100 U/kg) in addition to endocarditis prophylaxis (e.g., cefuroxime, l,5g, i.v.). Endocarditis prophylaxis is repeated afterthe procedure. Aspirin (100mg, p.d.) and clopidogrel (75mg/day, p.o.) are prescribed for six months after implantation. The incidence of thrombus formation varies between devices (50). If thrombus is seen during follow-up, coumadin therapy should be commenced. 

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See also in sourсe #XX -- [ ]

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