Anticoagulation and antiplatelet therapy in patients with prosthetic heart valves

J Card Surg. 2020 Dec;35(12):3521-3529. doi: 10.1111/jocs.15034. Epub 2020 Sep 16.

Abstract

Background: The choice of antithrombotic therapy, anticoagulants or antiplatelets, after prosthetic heart valve replacement or repair, remains a disputed topic in the literature. Antithrombotic therapies are used after heart valve intervention to reduce the rates of thromboembolic events, therefore improving patient outcomes. Different interventions may require different therapeutic regimens to achieve the most efficacious clinical outcome for patients.

Methods and discussion: This review aims to summarize and critique the available literature concerning therapeutic agents used for bioprosthetic and mechanical valves as well as for valve repair, so as to assist clinicians and researchers in making decisions with regard to their patients and research endeavors.

Keywords: DOAC; antiplatelets; thromboembolism; vitamin K antagonists; warfarin.

Publication types

  • Review

MeSH terms

  • Anticoagulants
  • Heart Valve Prosthesis*
  • Humans
  • Platelet Aggregation Inhibitors
  • Thromboembolism* / etiology
  • Thromboembolism* / prevention & control

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors