Anticoagulation or antiplatelet therapy of bioprosthetic heart valves recipients: an unresolved issue.
Improvements in the performance and longevity of biological valve prostheses have steadily increased their rates of implantation in recent years. Aortic bioprostheses, which are commonly used in the elderly or when the risks of anticoagulating are high, have generally been associated with low rates of long-term complications. Freedom from anticoagulation, therefore, represents the main theoretical advantage of biological, compared with mechanical, aortic prostheses. While a variety of anticoagulant and antiplatelet drug regimens have been described, a precise antithrombotic protocol for the early postoperative period after bioprosthetic aortic valve replacement has not been developed. There are also important differences between the international guidelines published. This review examines the clinical evidence concerning the use of vitamin K antagonist and antiplatelet therapy in the early management of the antithrombotic complications after bioprosthetic aortic valve replacement.
Colli
Andrea
A
Department of Cardiac Surgery, University of Parma, Italy. colli.andrea@libero.it
Verhoye
Jean-Philippe
JP
Leguerrier
Alain
A
Gherli
Tiziano
T
D000925:Anticoagulants / Q000627:therapeutic use*; D001021:Aortic Valve / Q000601:surgery; D001241:Aspirin / Q000627:therapeutic use; D001705:Bioprosthesis; D006350:Heart Valve Prosthesis; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013923:Thromboembolism / Q000517:prevention & control; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D001241:Aspirin