Thromboembolic and bleeding complications in patients with prosthetic heart valves at the Kenyatta National Hospital

Hungu EW1 MBChB, MMed (Surg),. Ogendo SWO2 MBChB, MMed (Surg), FCS (ECSA), 1. Lodwar District Hospital, 2. Department of Surgery, University of Nairobi. Corresponding surgeon: Eric Hungu. E-mail:


Background: Despite constant monitoring of anticoagulation in pros-thetic valve patients, haematologic complications occur. This study documented the occurrence of such complications and associated risk factors at the Kenyatta National Hospital (KNH).

Study design: Observational study reviewing 142 patients, 39 pro-spective and 103 retrospective.

Outcome measures: International Normalised Ratio (INR); presence of signs and symptoms of haematological complications.

Results: Forty four (31%) patients presented with bleeding tenden-cies, 28 grade I and 4 grade III. The most common thromboembolic complication was headache in 33 (23.2%) patients.


Mean duration of anticoagulation for patients with complications was 82.9 months (± 64), compared to 60.8 months (± 43.8) in those without.

Nine patients were non-compliant in taking medications, haematologic complications presenting in 8 of them.


Conclusion: A positive association was established between hema-tologic complications and INR levels, duration of anticoagulation therapy, non-compliance in taking of medications, and increased period between clinic visits.


Of these only the duration of anticoagulation was an independent predictor for haematological complications.



The Annals of African Surgery is the official publication of the Surgical Society of Kenya.


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