“Although the American Heart Association (AHA) and American College of Cardiology (ACC) and the American College of Chest Physicians (ACCP) provide guidelines on anticoagulation for patients with MHVs, limited guidance is provided for bridging anticoagulation 2,3 The guidelines are focused on preoperative bridging, with virtually no guidance on postoperative bridging.”

“Although thromboembolic risk in patients with MHVs is a concern, this risk must be balanced with perioperative bleeding risks. Although studies are limited in the MHV population, most have demonstrated that the risk of bleeding far exceeds the risk of thromboembolism with bridging anticoagulation. Our proposed bridging anticoagulation strategy accounts for current guidelines and allows a more individualized approach to anticoagulation in patients with MHV who undergo noncardiac surgical operations.”

Tan CW, et al How to bridge? Management of anticoagulation in patients with mechanical heart valves undergoing noncardiac surgical procedures. J Thorac Cardiovasc Surg. 2019 Jul;158(1):200-203. Free Full Text