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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Characterizing Antithrombotic Regimens After Isolated Mitral Valve Repair: A Retrospective Descriptive Study and
Jessie Jiang1, Ricky D Turgeon2, Eric Chu1
1Department of Pharmacy, Vancouver General Hospital, Vancouver, British Columbia, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
The American Journal of Cardiology
|April 18, 2026
Summary
Optimal antithrombotic therapy after mitral valve repair (MVr) lacks evidence, leading to varied practices. This study found significant heterogeneity in antithrombotic regimens and prescribing patterns post-MVr among patients and surgeons.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Pharmacology
Background:
- Optimal antithrombotic therapy following isolated surgical mitral valve repair (MVr) remains poorly defined.
- Current clinical practice exhibits considerable variability in antithrombotic regimen selection and duration.
Purpose of the Study:
- To characterize antithrombotic regimens prescribed after isolated surgical MVr.
- To elucidate the rationale behind prescribing practices for antithrombotic therapy post-MVr.
Main Methods:
- Retrospective descriptive study of 89 adult patients undergoing isolated MVr without other anticoagulation indications.
- Semi-structured interviews with 15 cardiac surgeons across Canada regarding their prescribing practices and rationale.
Main Results:
- Dual antiplatelet therapy (DAPT) and warfarin were the most common initial regimens (40% and 36%, respectively).
- Most patients received a 3-month initial therapy, followed by indefinite aspirin (80%).
- Surgeons cited convention and clinical experience, with differing rationales for anticoagulation versus antiplatelet therapy.
Conclusions:
- Substantial heterogeneity exists in antithrombotic regimens and prescribing patterns after isolated MVr.
- Lack of evidence contributes to variable clinical approaches, highlighting a need for standardized guidelines.
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