Document Detail

Anticoagulation for mechanical heart valves in patients with and without atrial fibrillation.
MedLine Citation:
PMID:  20425168     Owner:  NLM     Status:  In-Process    
Surgical replacement of a native valve with a biological or mechanical prosthesis is the definitive treatment for many forms of advanced valvular heart disease. Mechanical heart valves are less prone to structural deterioration compared with bioprostheses, but require chronic oral anticoagulation to prevent thromboembolic events. Thromboembolic risk varies based on patient-related risk factors, including atrial fibrillation, advanced age, low ejection fraction, and hypercoagulability. Other important correlates of high thromboembolic risk include valve design, valve position, anticoagulation variability, and time from surgery. Clinical management is further complicated when antithrombotics may need to be interrupted or altered during surgery or pregnancy. At present, vitamin K antagonists are the only approved agents for thromboprophylaxis but are limited because of a narrow therapeutic window and requirement for frequent monitoring. Novel anticoagulants, including inhibitors of factor IIa and Xa, are currently being evaluated and may emerge as alternatives to vitamin K antagonists.
Usman Baber; Sarina van der Zee; Valentin Fuster
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current cardiology reports     Volume:  12     ISSN:  1534-3170     ISO Abbreviation:  Curr Cardiol Rep     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888969     Medline TA:  Curr Cardiol Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  133-9     Citation Subset:  IM    
Mount Sinai School of Medicine, New York, NY 10029, USA.
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