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Anticoagulation in valvular heart disease preoperatively and postoperatively.
Cardiovascular Clinics
|January 1, 1984
Summary
Warfarin anticoagulation is recommended for rheumatic mitral valve disease with atrial fibrillation and for mechanical heart valve prostheses. Aortic bioprostheses generally require warfarin for only 3 months, while mitral bioprostheses may need indefinite treatment.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Cardiac valve disease necessitates careful management of anticoagulation.
- Standardized complication reporting and comparative studies for anticoagulation are limited.
Purpose of the Study:
- To review risks and benefits of anticoagulation for cardiac valve disease.
- To provide general recommendations for anticoagulation before and after valve surgery.
Main Methods:
- Review of existing literature on anticoagulation for cardiac valve disease.
- Formulation of general recommendations based on patient subgroups and valve types.
Main Results:
- Chronic warfarin is recommended for rheumatic mitral valve disease with atrial fibrillation and for mechanical prostheses.
- Aortic bioprostheses generally require warfarin for <3 months; mitral bioprostheses may require indefinite anticoagulation.
- Platelet-suppressant therapy is not routinely recommended but may benefit specific subsets.
Conclusions:
- Anticoagulation strategies vary based on valve type, patient condition (e.g., atrial fibrillation, heart failure), and surgical history.
- Close monitoring in specialized clinics is crucial for minimizing anticoagulation risks.
- Specific guidance is provided for anticoagulation during infective endocarditis, pregnancy, and noncardiac surgery.