This review summarizes recent developments and guidelines for managing anticoagulation with vitamin K antagonists in patients with valvar heart disease, including during non-cardiac surgery.
The indications for oral anticoagulant treatment have been extended over the last 10 years. The detection of new congenital thrombophilic risk factors, the studies on non-valvar atrial fibrillation, and the increase in valvar heart surgery have all led to a rise in the number of patients being treated. In 1997, 64 000 valve operations were performed across Europe; in two thirds of these operations mechanical prostheses were used, subsequently requiring lifelong oral anticoagulant treatment.w1 Several recent developments in the management of anticoagulation with vitamin K antagonists can potentially improve the efficacy and safety of this treatment. The guidelines developed by the working group on valvar heart disease of the European Society of Cardiology on the management of antithrombotic treatment in heart valve disease,2 together with the guidelines of the British Society of Haematology1 and the American Heart Association/American College of Cardiology (AHA/ACC),7have provided the basis …
Christa Gohlke-Bärwolf (Wed,) studied this question.