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European Heart Journal Advance Access published online on September 22, 2007
European Heart Journal, doi:10.1093/eurheartj/ehm405
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Improving the quality of anticoagulant therapy in patients with mechanical heart valves: what are we waiting for?

Paul Herijgers1,* and Peter Verhamme2

1 Department of Cardiac Surgery, K.U. Leuven, B-3000 Leuven, Belgium
2 Center for Molecular and Vascular Biology, K.U. Leuven, B-3000 Leuven, Belgium

* Corresponding author. Tel: +32 16 344260; fax: +32 16 344616. E-mail address: paul.herijgers@med.kuleuven.be

This editorial refers to ‘Low dose oral anticoagulation in patients with mechanical heart valve prostheses: final report from the Early Self-management Anticoagulation Trial II’ by H. Koertke et al., doi:10.1093/eurheartj/ehm391

The first 10% of the full text of this article appears below.

The replacement of destroyed heart valves by mechanical, thrombogenic prostheses would be hard to imagine without the availability of anticoagulant treatment. Coumarins were introduced in clinical practice during and shortly after the Second World War, in the same era that heart valve replacement surgery was pioneered. Still today, vitamin K antagonists are the only available oral anticoagulants for chronic use in patients with mechanical heart valves. Has no progress been made in this field over the past 50 years?

Mechanical heart valves and anticoagulation

Thromboembolic complications and bleedings comprise up to 75% of all complications after mechanical heart valve surgery and predominantly occur in the first year after surgery. For obvious reasons, well-controlled data on the incidence of thromboembolism in the absence of anticoagulation are scarce. The incidence of major thromboembolism in patients with aortic heart valves is roughly estimated as between 4 and 12% per . . . [Full Text of this Article]

Coumarins

Self-monitoring and self-management to improve the quality of anticoagulation

Unresolved issues and call for action


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Related articles in EHJ:

Low-dose oral anticoagulation in patients with mechanical heart valve prostheses: final report from the early self-management anticoagulation trial II
Heinrich Koertke, Armin Zittermann, Gero Tenderich, Otto Wagner, Mahmoud El-Arousy, Arno Krian, Juergen Ennker, Uwe Taborski, Wolf Peter Klövekorn, Rainer Moosdorf, Werner Saggau, and Reiner Koerfer
EHJ 2007 28: 2479-2484. [Abstract] [FREE Full Text]