Related Experiment Video

Updated: Oct 29, 2025

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

11.6K

Anticoagulation Therapy After Biologic Aortic Valve Replacement

Monna E Myllykangas1,2, Tuomas O Kiviniemi3,4, Jarmo M Gunn3,5

  • 1Department of Anesthesiology, Intensive Care, Emergency Care, and Pain Medicine, University of Turku, Turku, Finland.

Frontiers in Cardiovascular Medicine
|July 8, 2021
PubMed

Insights

Oral anticoagulation (OAC) after biologic aortic valve replacement (BAVR) may increase stroke risk but decrease death risk. Further research is needed to confirm these findings for long-term patient outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Medical Informatics

Background:

  • Standard practice recommends 3-month thromboembolism prophylaxis post-biologic aortic valve replacement (BAVR).
  • The long-term impact of continuing oral anticoagulation (OAC) therapy after this period remains unclear.
  • Understanding OAC's role in BAVR patients is crucial for optimizing post-operative care.

Purpose of the Study:

  • To investigate the association between continued oral anticoagulation (OAC) use and long-term prognosis after BAVR.
  • To evaluate the effects of OAC on mortality, stroke incidence, and major bleeding events in BAVR patients.

Main Methods:

  • Utilized nationwide register data encompassing 4,079 individuals who underwent BAVR between 2010 and 2016.
  • Compared outcomes between patients using warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) and those not on OAC.
  • Analyzed the risks of death, stroke, and major bleeding associated with OAC use.

Main Results:

  • OAC users exhibited a significantly higher risk of stroke (HR 2.39, p < 0.001) compared to non-users.
  • Conversely, OAC use was associated with a lower risk of death (HR 0.79, p = 0.016).
  • No significant association was found between OAC use and the risk of major bleeding.

Conclusions:

  • Oral anticoagulation use following BAVR appears linked to an elevated stroke risk but a reduced risk of mortality.
  • These observational findings highlight a complex risk-benefit profile for OAC in BAVR patients.
  • Randomized controlled trials are necessary to validate these results and inform clinical decision-making.

Keywords:
anticoagulationaortic valvebioprosthetic valveheart valve diseaseheart valve surgery

More Related Videos

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.6K
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

14.3K

Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
72
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
91
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.5K
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
1.1K
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
63
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
781