Heart valve disease module 7: anti-thrombotic therapy for valvular heart disease

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Heart failure - BJC Learning programme
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Prosthetic heart valves

Bioprosthetic valves and valve repair

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Figure 2. Types of biological valve

One of the important advantages of bioprosthetic valves (see figure 2) is that they do not require long-term anticoagulation unless there is another indication such as AF. However the first three months after implantation are a period of higher risk for thromboembolism, especially with mitral valves, though the evidence for which antithrombotic regime to use remains weak.

For conventionally implanted aortic prostheses, low-dose aspirin is indicated for the first three months after implantation. Anticoagulation with a VKA or NOACs (to be covered later) should be used instead for those who are in AF.