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

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Heart failure - BJC Learning programme
For healthcare professionals only

Prosthetic heart valves

Bioprosthetic valves and valve repair

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.