Bridging Anticoagulation with Mechanical Heart Valves: Current Guidelines and Clinical Decisions.

Abstract

PURPOSE OF REVIEW:

The management of patients with mechanical heart valves who require surgery or invasive procedures is a common clinical scenario in contemporary practice. The risk of thromboembolism versus the risk of bleeding is the foundation of optimal patient care.

RECENT FINDINGS:

Randomized, controlled trials are not available; yet, there is a wealth of experience to guide best practice. Current guidelines represent a compilation of data from trials of atrial fibrillation and expert opinion. Results from the PERI-OP trial of patients with either a mechanical heart valve, atrial fibrillation, or atrial flutter requiring interruption of oral anticoagulant therapy for surgery will inform clinical practice. Patient-specific factors and valve-specific factors are paramount when deciding whether a period of anticoagulant therapy interruption is safe. Similarly, the safety and efficacy of bridging anticoagulant therapy and the optimal time after surgery for restarting oral anticoagulants is vital to optimal patient care.

• Authors: Mahboob Ali, Richard C Becker
• Journal: Current cardiology reports (Curr Cardiol Rep) Vol. 22 Issue 11 Pg. 130 (09 10 2020) ISSN: 1534-3170 [Electronic] United States
• PMID: 32910313 (Publication Type: Journal Article, Review)

Chemical References

• Anticoagulants

Topics

• Anticoagulants (therapeutic use)
• Atrial Fibrillation (complications, drug therapy)
• Heart Valve Prosthesis
• Heart Valves
• Hemorrhage
• Humans
• Thromboembolism (prevention & control)