Antithrombotic treatment after heart valve surgery is of utmost importance depending on
the type of used valve. Since in the early 1960s, oral anticoagulation with vitamin K antagonist are
the gold-standard for prevention of thromboembolism at replaced heart valves. The introduction of
new oral anticoagulation has dramatically changed treatment strategy in patients with atrial
fibrillation and in patients with venous thromboembolism like deep vein thrombosis and pulmonary
embolism. However, to date, the use of these newer drugs is contraindicated after implantation of
mechanical heart valves for prevention of thromboembolism. Large trial revealed significantly higher rates of
thromboembolism and bleeding events as compared to oral anticoagulation. Further studies are required to evaluate the
several newer oral anticoagulations in patients with mechanical heart valve.
Keywords: Coumadin, heart valve, novel oral anticoagulation, surgery, warfarin.
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