Antithrombotic Therapy in Mechanical and Biological Prosthetic Heart Valves and Saphenous Vein Bypass Grafts

Abstract

Mechanical prosthetic heart valves are well-recognized sources of thromboemboli, and the medical literature suggests that the risk of thromboembolism with all mechanical valves is sufficiently high to warrant lifetime anticoagulant therapy. In view of the hemorrhage risks of lifelong anticoagulant therapy, the question of clinical relevance at this time is whether the dose of warfarin can be effectively reduced or whether antiplatelet agents can safely be substituted or used in combination with lower doses of warfarin.