Modern management of prosthetic valve anticoagulation

Daniel J. Tiede, Rick A. Nishimura, Dennis A. Gastineau, Charles J. Mullany, Thomas A. Orszulak, Hartzell V. Schaff

Research output: Contribution to journalReview articlepeer-review

88 Scopus citations


Prosthetic heart valves have been effectively used for many years. Nonetheless, they are associated with risks of thrombosis and thromboembolic events, as well as anti. coagulation-induced bleeding. Substantial changes in anticoagulation measurement and dosing have occurred during the past several years. In this review, the rationale for anticoagulation in patients with prosthetic heart valves, the changes in monitoring and dosing, and the comparison of relevant anticoagulation trials are discussed. On the basis of the existing data, new recommendations regarding lower anticoagulation levels are offered, utilizing a single value goal rather than the traditional therapeutic range. Perioperative management of anticoagulation is discussed in light of the available literature, and major drug interactions are reviewed.

Original languageEnglish (US)
Pages (from-to)665-680
Number of pages16
JournalMayo Clinic proceedings
Issue number7
StatePublished - 1998

ASJC Scopus subject areas

  • Medicine(all)


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