E. Warfarin + aspirin – Explanation
Prosthetic heart valves – antithrombotic therapy:
- bioprosthetic: aspirin
- mechanical: warfarin + aspirin
Prosthetic heart valves
The most common valves which need replacing are the aortic and mitral valve. There are two main
options for replacement: biological (bioprosthetic) or mechanical.
| Biological (bioprosthetic) valves | Mechanical valves |
| Usually bovine or porcine in origin Major disadvantage is structural deterioration and calcification over time. Most older patients ( > 65 years for aortic valves and > 70 years for mitral valves) receive a bioprosthetic valve Long-term anticoagulation not usually needed. Warfarin may be given for the first 3 months depending on patient factors. Low-dose aspirin is given long-term |
.The most common type now implanted is the bileaflet valve. Ball-andcagevalves are rarely used nowadays Mechanical valves have a low failure rate Major disadvantage is the increased risk of thrombosis meaning longtermanticoagulation is needed. Aspirin is normally given in additionunless there is a contraindication. Target INR
|
Following the 2008 NICE guidelines for prophylaxis of endocarditis antibiotics are no longer
recommended for common procedures such as dental work.
