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Low-dose anticoagulation therapy can be used safely with new design mechanical heart valve
Date:5/15/2014

Beverly, MA, May 15, 2014 Less aggressive anticoagulation therapy, combined with low-dose aspirin, can be used safely in conjunction with a newer generation mechanical heart valve. These findings from the first phase of a randomized clinical trial are published in The Journal of Thoracic and Cardiovascular Surgery, an official publication of the American Association for Thoracic Surgery.

Patients under 65 years of age requiring heart valve replacement have had to choose between a mechanical valve that may last a lifetime but requires aggressive anti-clotting treatment with warfarin, and a biological (cow or pig) valve that does not require warfarin treatment but will need replacement in 10-20 years. Aggressive anti-clotting treatment is accompanied by significant risk of bleeding, while inadequate treatment can result in an increased incidence of stroke.

Therefore, the choice between valve types for physicians and patients narrows to one of avoidance of the risk, pain, and costs of reoperation for valve obsolescence versus avoidance of the lifetime composite risk of bleeding and thromboembolism and the nuisance of ongoing anticoagulation management. Both valve types can develop complications which, although rare, can result in reoperation, stroke, or death.

The US Food and Drug Administration (FDA) approved a randomized trial to test the safety of less aggressive anti-clotting treatment than the American Heart Association/American College of Cardiology guidelines currently recommend, in patients implanted with a newer generation On-X heart valve. "This is a bileaflet mechanical valve approved by the FDA, which is designed to function with less anticoagulation, or in some cases, antiplatelet therapy only," explains John D. Puskas, MD, Professor of Cardiothoracic Surgery at the Icahn School of Medicine at Mount Sinai, and Chairman of the Department of Cardiothoracic Surgery, Mount Sinai Beth Israel, New York, NY.

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Contact: Nicole Baritot
press@aats.org
978-299-4520
American Association for Thoracic Surgery
Source:Eurekalert

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