title: Challenges in managing anticoagulant therapy in patients with heart valve prostheses.
abstract: There is a wide array of recommendations for the management of anticoagulant therapy in patients with mechanical heart valves. The optimal intensity of vitamin K antagonists, management of patients during noncardiac surgery and use of anticoagulants during pregnancy are all ongoing matters of debate. In this review, we discuss the various studies on these topics and the different guidelines. Based on these, literature recommendations for daily clinical practice are formulated.
authors.affiliation: University of Amsterdam, Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands. r.vink@amc.uva.nl
authors.forename: Roel
authors.initials: R
authors.lastname: Vink
authors.forename: Pieter-Willem
authors.initials: PW
authors.lastname: Kamphuisen
authors.forename: Renée B
authors.initials: RB
authors.lastname: van den Brink
authors.forename: Marcel
authors.initials: M
authors.lastname: Levi
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D000075202:Contraindications; D006350:Heart Valve Prosthesis; D006801:Humans; D013514:Surgical Procedures, Operative; D013923:Thromboembolism / Q000517:prevention & control*; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D014812:Vitamin K