Optimal anticoagulation in patients with atrial fibrillation and bioprosthetic heart valves

Bottino, Roberta; Carbone, Andreina; Liccardo, Biagio; Imbalzano, Egidio; D’Andrea, Antonello; Russo, Vincenzo

doi:10.33963/kp.a2022.0051

Cited by 3 publications

(2 citation statements)

References 56 publications

(121 reference statements)

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“…Recently, Bottino and colleagues published a review on this topic and made conclusions regarding the use of DOACs in bioprosthetic valve patients. Ultimately, they highlighted the lack of definitive data for a clear recommendation and emphasized that decisions should be based on individual patients 17 . Our case highlights the development of thrombus and subsequent early degeneration with an effective anticoagulant dose of apixaban below 5 mg, even in aortic bioprosthetic valves with relatively low thrombosis risk.…”

Section: Discussionmentioning

confidence: 90%

Bioprosthetic aortic valve thrombosis under effective direct oral anticoagulant therapy

et al. 2023

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With the increase in transcatheter procedures, the use of bioprosthetic valves has become more frequent in clinical practice. However, the optimal antithrombotic management of patients with bioprosthetic valves remains controversial. In this case report, we describe a patient with a bioprosthetic aortic valve who developed a thrombus while receiving effective dose direct oral anticoagulant (DOAC) therapy. A 73‐year‐old male patient with a bioprosthetic aortic valve replacement 2 years prior presented with a mobile thrombus and early degeneration of the valve, detected during routine follow‐up while being treated with apixaban. Although the valve thrombus regressed after switching to a different anticoagulant drug, we observed that the decreased but still high gradient persisted due to the early degeneration. Anticoagulant management of bioprosthetic valve patients demands careful attention. Although evidence supporting the use of DOACs is growing, close patient follow‐up and further evaluation in case of doubt remain critical. The development of a thrombus in a bioprosthetic valve patient who is receiving anticoagulation therapy, as in this case, highlights the need for optimal management to prevent thromboembolic complications and valve degeneration.

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Section: Discussionmentioning

confidence: 90%

Bioprosthetic aortic valve thrombosis under effective direct oral anticoagulant therapy

et al. 2023

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“…The frequency of anticoagulation-related keywords was the highest in the last decade. Anticoagulation therapy remains a challenging aspect of medical management, especially for patients undergoing valve replacement ( 43 ). Currently, researchers have shown interest in developing anticoagulant health management models using the internet and smart devices with a focus on self-management.…”

Section: Discussionmentioning

confidence: 99%

Effective health management strategies for patients undergoing valve replacement: a bibliometric analysis of the current research status and future directions

Wang,

Wu,

et al. 2024

Front. Cardiovasc. Med.

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BackgroundValvular heart disease is a major health concern worldwide. The effective management of patients undergoing valve replacement determines their prognosis. Bibliometric analysis of studies on managing patients with artificial heart valves has not been previously performed.MethodsThis study analyzed 2,771 publications related to patient management after valve replacement published in the Web of Science Core Collection database between January 1, 2013, and December 31, 2022. Bibliometric analysis was performed using CiteSpace and VOSviewer considering countries, institutions, authors, journals, references, and keywords.ResultsThe countries with the most significant contributions in this field were the United States of America (USA), Germany, and Italy. Leon MB from Columbia University, USA was the most influential author. Transcatheter aortic valve replacement was a current research hotspot, while anticoagulation management was a key area of interest. Combining anticoagulation therapy with internet-linked tools and portable health devices may offer new research avenues. Frailty assessment and intervention were potential future research areas.ConclusionsThis bibliometric analysis provides clinicians and researchers with useful insights for developing novel ideas and directions to manage the health of patients undergoing valve replacement.

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Direct Oral Anticoagulants for Stroke Prevention in Special Populations: Beyond the Clinical Trials

et al. 2023

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Currently, direct oral anticoagulants (DOACs) are the first-line anticoagulant strategy in patients with non-valvular atrial fibrillation (NVAF). They are characterized by a more favorable pharmacological profile than warfarin, having demonstrated equal efficacy in stroke prevention and greater safety in terms of intracranial bleeding. The study population in the randomized trials of DOACs was highly selected, so the results of these trials cannot be extended to specific populations such as obese, elderly, frail, and cancer patients, which, on the other hand, are sub-populations widely represented in clinical practice. Furthermore, due to the negative results of DOAC administration in patients with mechanical heart valves, the available evidence in subjects with biological heart valves is still few and often controversial. We sought to review the available literature on the efficacy and safety of DOACs in elderly, obese, underweight, frail, cancer patients, and in patients with bioprosthetic heart valves with NVAF to clarify the best anticoagulant strategy in these special and poorly studied subpopulations.

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Optimal anticoagulation in patients with atrial fibrillation and bioprosthetic heart valves

Cited by 3 publications

References 56 publications

Bioprosthetic aortic valve thrombosis under effective direct oral anticoagulant therapy

Bioprosthetic aortic valve thrombosis under effective direct oral anticoagulant therapy

Effective health management strategies for patients undergoing valve replacement: a bibliometric analysis of the current research status and future directions

Direct Oral Anticoagulants for Stroke Prevention in Special Populations: Beyond the Clinical Trials

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