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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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[Anticoagulation after heart valve replacement]

Frederik Voss1, Christoph Sucker2,3, Jens Litmathe4

  • 1Herzzentrum Trier/Abteilung für Rhythmologie, Krankenhaus der Barmherzigen Brüder, Nordallee 1, 54292, Trier, Deutschland. f.voss@bk-trier.de.

Wiener Medizinische Wochenschrift (1946)
|May 5, 2021
PubMed

Insights

Patients with mechanical heart valves require anticoagulation with vitamin K antagonists (VKA). Non-vitamin K antagonists (NOAC) are contraindicated, but this review covers anticoagulation for various valve replacements and clinical scenarios.

Area of Science:

  • Cardiology
  • Hematology
  • Pharmacology

Context:

  • Mechanical heart valve replacement necessitates lifelong anticoagulation to prevent thrombotic and thromboembolic events.
  • Current guidelines restrict oral anticoagulation in this population to vitamin K antagonists (VKA).
  • Non-vitamin K dependent oral anticoagulants (NOAC) are contraindicated in patients with mechanical heart valves.

Purpose:

  • To review current anticoagulation strategies for patients with mechanical heart valve replacement.
  • To discuss coagulation inhibition following bioprosthetic or percutaneous valve replacement.
  • To provide recommendations for antithrombotic medication in various clinical scenarios for patients with mechanical heart valves.

Summary:

  • This review focuses on anticoagulation management in patients with mechanical heart valves, emphasizing the exclusive role of VKAs.
  • It also addresses anticoagulation after bioprosthetic or percutaneous valve procedures.
  • Evidence-based recommendations for antithrombotic therapy in diverse clinical situations are presented.

Impact:

  • Provides critical guidance for clinicians managing anticoagulation in patients with prosthetic heart valves.
  • Highlights the limitations of NOACs in mechanical heart valve patients.
  • Aims to optimize antithrombotic strategies, reducing thromboembolic risks and improving patient outcomes.

Keywords:
AnticoagulationReviewValve replacementWarfarin

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