Cor Vasa 2013, 55(2):e158-e163 | DOI: 10.1016/j.crvasa.2013.01.008

Antithrombotic therapy in valvular heart disease and artificial valves

Hana Línková*, Róbert Petr
III. interní-kardiologická klinika, Kardiocentrum 3. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha, Česká republika

The article summarizes the current recommendations and knowledge for the treatment of patients with artificial valves. The attention is focused on antithrombotic therapy after valve replacement, including possible complications of the treatment, particularly thromboembolic and bleeding complications. We review the procedures when the anticoagulation must be interrupted. The possibilities of improving therapy in patients that require permanent anticoagulation and the outlook for the future are discussed.

Keywords: Antiagregation; Anticoagulation; Aspirin; Bioprosthesis; Embolism; Low molecular weight heparin; Mechanical prosthesis; Native valves; Thrombosis; Unfractionated heparin

Received: November 23, 2012; Revised: January 18, 2013; Accepted: January 20, 2013; Published: April 1, 2013  Show citation

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Línková H, Petr R. Antithrombotic therapy in valvular heart disease and artificial valves. Cor Vasa. 2013;55(2):e158-163. doi: 10.1016/j.crvasa.2013.01.008.
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References

  1. A. Vahanian, O. Alfieri, F. Andreotti, et al., Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS), Guidelines on the management of valvular heart disease, European Heart Journal 33 (2012) 2451-2496. Go to original source... Go to PubMed...
  2. A. Vahanian, H. Baumgartner, J. Bax, et al., The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology,Guidelines on the management of valvular heart disease, European Heart Journal 28 (2007) 230-268. Go to original source...
  3. R.O. Bonow, B.A. Carabello, K. Chatterjee, et al., American College of Cardiology, American Heart Association Task Force on Practice Guidelines, ACC/AHA 2006 guidelines for the management of patients with valvular heart disease, Journal of the American College of Cardiology 48 (2006) e1-e148. Go to original source... Go to PubMed...
  4. J. Popelová, M. Brtko, M. Benešová, et al., Doporučené postupy pro diagnostiku a léčbu chlopenních srdečních vad v dospělosti, Cor et Vasa 49 (7-8) (2007) K195-K234.
  5. G.H. Guyatt, E.A. Akl, M. Crowther, et al., Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed., American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, Chest 141 (2 Suppl) (2012) 7S-47S. Go to original source...
  6. J.C. Sun, M.J. Davidson, A. Lamy, et al., Antithrombotic management of patients with prosthetic heart valves: current evidence and future trends, Lancet 374 (2009) 565-576. Go to original source... Go to PubMed...
  7. G. Laplace, S. Lafitte, J.N. Labeque, et al., Clinical significance of early valve thrombosis after prosthetic mitral valve replacement, Journal of the American College of Cardiology 43 (2004) 1283-1290. Go to original source... Go to PubMed...
  8. P. Meurin, J.Y. Tabet, H. Weber, et al., Low-molecular-weight heparin as a bridging anticoagulant early after mechanical heart valve replacement, Circulation 113 (2006) 564-569. Go to original source... Go to PubMed...
  9. A. Colli, J.P. Verhoye, R. Heijmen, et al., Antithrombotic therapy after bioprosthetic aortic valve replacement: ACTION Registry survey results, European Journal of Cardio-thoracic Surgery 33 (4) (2008) 531-536. Go to original source... Go to PubMed...
  10. E.D. Butchart, Antithrombotic management in patients with prostetic valves. A comparsion of American and European Guidelines, Heart 95 (2009) 430-436. Go to original source... Go to PubMed...
  11. E.G. Butchart, C. Gohlke-Bärwolf, M.J. Antunes, et al., Recommendations for the management of patients after heart valve surgery, European Heart Journal 26 (2005) 2463-2471. Go to original source... Go to PubMed...
  12. W. Dewilde, T. Oirbans, F. Verhauf, et al., WOEST trial, ESC 2012 Hotline, www.escardio.org
  13. D.N. Salem, P.D. Stein, A. Al-Ahmad, et al., Antithrombotic therapy in valvular heart disease, native and prosthetic, Chest 126 (2004) 457S-482S. Go to original source... Go to PubMed...
  14. D.R. Holmes, D.J. Kereiakes, N.S. Kleiman, et al., Combining antiplatelet and anticoagulant therapies, Journal of the American College of Cardiology 54 (2009) 95-109. Go to original source... Go to PubMed...
  15. M. Rossi, G.F. Serraino, A. Spadafora, et al., What do you do with the antiplatelet agents in patients with drug eluting stents who then receive a mechanical valve?, Interactive Cardiovascular and Thoracic Surgery 15 (2012) 115-121. Go to original source... Go to PubMed...
  16. D. Hering, C. Piper, D. Horstkotte, Management of prosthetic valve trombosis, European Heart Journal Supplements 3 (Supplement) (2001) Q22-Q26. Go to original source...
  17. J. Dunning, M. Versteegh, M. Fabbri, et al., Guideline on antiplatelet and anticoagulation management in cardiac surgery, European Journal of Cardio-thoracic Surgery 34 (2008) 73-92 Go to original source... Go to PubMed...
  18. W.S. Chan, S. Anand, J.S. Ginsberg, Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature, Archives of Internal Medicine 160 (2) (2000) 191-196. Go to original source... Go to PubMed...
  19. J.S. Ginsberg, W.S. Chan, S.M. Bates, S. Kaatz, Anticoagulation of pregnant women with mechanical heart valves, Archives of Internal Medicine 163 (6) (2003) 694-698. Go to original source... Go to PubMed...
  20. G. Hanania, Management of anticoagulants during pregnancy, Heart 86 (2) (2001) 125-126. Go to original source... Go to PubMed...
  21. L. Maegdefessel, J.M. Spin, J. Azuma, et al., New options with dabigatran etexilate in anticoagulant therapy, Vascular Health Risk Management 6 (2010) 339-349. Go to original source... Go to PubMed...
  22. H. Koertke, A. Zittermann, G. Tenderich, Low-dose oral anticoagulation in patients with mechanical heart valve prostheses: final report from the early self-management anticoagulation trial II, European Heart Journal 28 (20) (2007) 2479-2484. Go to original source... Go to PubMed...
  23. P. Herijgers, P. Verhamme, Improving the quality of anticoagulant therapy in patients with mechanical heart valves: what are we waiting for?, European Heart Journal 28 (2007) 2424-2426. Go to original source... Go to PubMed...
  24. M. Benešová, Antitrombotická terapie po operacích chlopní - současná doporučení a budoucí trendy, Časopis lékařů českých 150 (2011) 229-235. Go to PubMed...




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