Should we anticoagulate after bioprosthetic aortic valve replacement?

Talal Al-Atassi, Hadi Toeg, Marc Ruel*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

There is a lack of consensus as to the ideal antithrombotic strategy after bioprosthetic aortic valve replacement. Herein, the authors review the literature on this topic and find that most of the evidence is comprised of small observational data, with a few prospective trials. The bulk of the evidence is in favor of no anticoagulation after bioprosthetic aortic valve replacement in patients at low risk of thromboembolism. Most studies suggest using only antiplatelet therapy with the exception of two studies that advocate anticoagulation. One study suggests that no antithrombotic therapy at all may be safe. One study evaluated the question mechanistically, showing no increased microembolic signals on transcranial Doppler in patients receiving aspirin compared to patients who were anticoagulated. Based on the evidence presented, the authors recommend using aspirin only after bioprosthetic aortic valve replacement in patients at low risk of thromboembolism.

Original languageEnglish (US)
Pages (from-to)1649-1657
Number of pages9
JournalExpert review of cardiovascular therapy
Volume11
Issue number12
DOIs
StatePublished - Nov 26 2013

Keywords

  • Anticoagulation
  • Antiplatelet
  • Antithrombotic
  • Aortic valve replacement
  • Bioprosthetic aortic valve

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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