Voss Frederik, Sucker Christoph, Litmathe Jens
Herzzentrum Trier/Abteilung für Rhythmologie, Krankenhaus der Barmherzigen Brüder, Nordallee 1, 54292, Trier, Deutschland.
Medizinisches Versorgungszentrum (MVZ) COAGUMED Gerinnungszentrum, Berlin, Deutschland.
Wien Med Wochenschr. 2023 Mar;173(3-4):84-89. doi: 10.1007/s10354-021-00845-7. Epub 2021 May 5.
In patients after mechanical heart valve replacement anticoagulation is required for the prevention of thrombotic and thromboembolic events. In this setting oral anticoagulation can only be performed with vitamin K antagonists (VKA), while currently all available non-vitamin K dependent oral anticoagulants (NOAC) are contraindicated in patients with mechanical heart valve replacement. This review deals with anticoagulation in patients with mechanical heart valve replacement as well as coagulation inhibition after bioprosthetic or percutaneous valve replacement. In addition, recommendations are given for antithrombotic medication in patients with mechanical heart valve replacement in various clinical scenarios.
在接受机械心脏瓣膜置换术的患者中，需要进行抗凝治疗以预防血栓形成和血栓栓塞事件。在这种情况下，口服抗凝只能使用维生素K拮抗剂（VKA），而目前所有可用的非维生素K依赖型口服抗凝剂（NOAC）在接受机械心脏瓣膜置换术的患者中均为禁忌。本综述涉及机械心脏瓣膜置换术患者的抗凝治疗以及生物瓣膜或经皮瓣膜置换术后的凝血抑制。此外，还针对各种临床情况下机械心脏瓣膜置换术患者的抗血栓药物治疗给出了建议。
