Anticoagulation After Heart Valve Replacement or Transcatheter Valve Implantation.


Journal Article (Review)

Valvular heart disease is prevalent and represents a significant contributor to cardiac morbidity and mortality. Several options for valve replacement exist, including surgical replacement and transcatheter valve implantation. Prosthetic valves lead to increased risk of thromboembolic disease; therefore, antithrombotic therapy after valve replacement is indicated. For patients with mechanical prostheses, indefinite vitamin K antagonist and antiplatelet therapy are the mainstays of treatment. There is no consensus regarding optimal antithrombotic therapy after bioprosthetic valve replacement, although vitamin K antagonist therapy of varying duration in addition to antiplatelet therapy is recommended by guidelines. Dual-antiplatelet therapy is commonly used after transcatheter valve implantation; however, alternative antithrombotic regimens are being studied. Further studies are needed to identify the optimal regimen, intensity, and duration of antithrombotic therapy after surgical bioprosthetic valve replacement and transcatheter valve implantation.

Full Text

Duke Authors

Cited Authors

  • Carnicelli, AP; O'Gara, PT; Giugliano, RP

Published Date

  • November 2016

Published In

Volume / Issue

  • 118 / 9

Start / End Page

  • 1419 - 1426

PubMed ID

  • 27666180

Pubmed Central ID

  • 27666180

Electronic International Standard Serial Number (EISSN)

  • 1879-1913

International Standard Serial Number (ISSN)

  • 0002-9149

Digital Object Identifier (DOI)

  • 10.1016/j.amjcard.2016.07.048


  • eng