Antithrombotic and Thrombolytic Therapy for Valvular Disease

Abstract

These antithrombotic guidelines provide recommendations based on the optimal balance of thrombotic and hemorrhagic risk.

Use of Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Valvular Heart Lesions

“…According to the current ACC/AHA and ACCP guidelines for VHD, anticoagulation with a VKA or heparin is recommended in patients with AF and mitral stenosis. Anticoagulation should be continued indefinitely in patients with mitral stenosis and concurrent AF, a prior embolic event, or a left atrial thrombus 27, 28…”

Coexisting Cardiac and Hematologic Disorders

“…hypercoagulable state, previous thrombotic event) is 2.5 38 . Although major guidelines differ in their specific recommendation, aspirin, in addition to warfarin, is generally recommended in those without increased bleeding risk [38][39][40] .…”

Cardiological Aspects of Stroke Prevention

“…Mitral stenosis with enlarged LA (≥55 mm in diameter) is associated with increased IS risk and anticoagulation should be considered. 36 In contrast to mitral valve stenosis, the risk of IS in patients with mitral valve prolapse is less clear. 37, 38 Mitral regurgitation in patients without AF probably does not significantly increase the risk of IS.…”

“…There is no role for treatment of bacterial endocarditis with anticoagulation absent another indication; instead appropriate antibiotic therapy is the definitive treatment. 36 …”