Antithrombotic management of patients with prosthetic heart valves: current evidence and future trends.
Over 4 million people worldwide have received a prosthetic heart valve, and an estimated 300,000 valves are being implanted every year. Prosthetic heart valves improve quality of life and survival of patients with severe valvular heart disease, but the need for antithrombotic therapy to prevent thrombotic complications in valve recipients poses challenges for clinicians and patients. Here, we review antithrombotic therapies for patients with prosthetic heart valves and management of thromboembolic complications. Advances in antithrombotic therapy and valve technologies are likely to improve the management of patients with prosthetic heart valves in developed countries, but the most important unmet need and potential for benefit from these new therapies is in developing countries where a massive and rapidly increasing burden of valvular heart disease exists.
Sun
Jack C J
JC
Division of Cardiac Surgery, McMaster University, Hamilton, ON, Canada. sunjc2@mcmaster.ca
Davidson
Michael J
MJ
Lamy
Andre
A
Eikelboom
John W
JW
D000465:Algorithms; D001705:Bioprosthesis / Q000009:adverse effects; D017281:Cost of Illness; D019049:Developed Countries; D003906:Developing Countries; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005544:Forecasting; D014943:Global Health; D006301:Health Services Needs and Demand; D006349:Heart Valve Diseases / Q000453:epidemiology / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects* / Q000145:classification / Q000639:trends; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000706:statistics & numerical data; D006801:Humans; D019647:Oral Surgical Procedures; D017410:Practice Guidelines as Topic; D011292:Premedication; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome
D005343:Fibrinolytic Agents