{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T01:55:16Z","timestamp":1755222916478,"version":"3.43.0"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1047951125101194_as1\">\n\t    <jats:title>Introduction:<\/jats:title>\n\t    <jats:p>Surgical pulmonary valve replacement is commonly required to palliate patients with CHD affecting the right ventricular outflow tract; however, concerns remain about mid- and long-term durability. Post-operative short-term anticoagulation has been hypothesised to improve valve durability.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1047951125101194_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>This is a single-centre, retrospective study of paediatric patients who underwent surgical pulmonary valve replacement and received a direct oral anticoagulant in addition to aspirin post heart valve insertion. The primary objective was a composite safety score consisting of clinically relevant non-major bleeding, major bleeding, bleeding-related readmission, and medication discontinuation.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1047951125101194_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>The study analysed 34 patients with a median age 14 years (Interquartile range (IQR): 11, 15) and weight 45 kg (IQR: 35, 55). Ten patients met the composite endpoint (10\/34, 29%), with 4 patients experiencing major bleeding (4\/34, 12%), 6 experiencing clinically relevant non-major bleeding (6\/34, 18%), and 3 patients being readmitted within 90 days of surgical pulmonary valve replacement for bleeding (3\/29, 8.8%) resulting in 10 patients discontinuing medication early (10\/34, 29%). Lower weight was identified as a significant risk factor for adverse event development (<jats:italic>p<\/jats:italic> = 0.04).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1047951125101194_as4\">\n\t    <jats:title>Conclusion:<\/jats:title>\n\t    <jats:p>We observed a higher overall bleeding rate, driven predominately by clinically relevant non-major bleeding events, than other studies using short-term anticoagulation after surgical pulmonary valve replacement. Additional studies should be aimed at evaluating the dosing and safety of direct oral anticoagulants in children in the post-operative period.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s1047951125101194","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T08:00:36Z","timestamp":1754899236000},"page":"1-6","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Safety of direct oral anticoagulants in surgical bioprosthetic heart valves: a paediatric institution\u2019s experience"],"prefix":"10.1017","author":[{"given":"Daniela","family":"Barisano","sequence":"first","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gwen","family":"Nance","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of 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