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Flashcards in Valvular Disease Deck (9)
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1

On-X Valve INR goals

2 - 3 for the first 90 days, then 1.5 - 2.0

2

Bioprosthetic Valve Duration

2 - 3 months, at most 6 months before stopping anticoagulation

3

Mechanical valve antithrombotic therapy

warfarin and ASA 81 mg daily indefinitely

4

Bioprosthetic valve antithrombotic therapy

warfarin OR DOAC and ASA 81 mg daily for 3 - 6 months, then ASA 81 mg daily indefinitely

5

TAVR antithrombotic therapy

Clopidogrel + ASA 81 mg daily (DAPT) for 3 - 6 months, then ASA 81 mg daily indefinitely

6

Which DOAC had a greater risk of bleeding for "valvular" Afib?

Rivaroxaban - ROCKET AF

7

What to do if bioprosthetic valve thrombus if clinically unstable?

Surgical repair > thrombolysis
Step up therapy for long term

8

What to do if mechanical valve and pregnancy?

First 36 weeks:
Peripartum:
24 hours before delivery:
12 hours before delivery:
4 - 6 hours before neuraxial anesthesia:
4 - 6 hours after delivery:
5 - 7 days after delivery:

First 36 weeks, start warfarin at low daily dose (less than 5 mg daily) OR LMWH and ASA 81 mg
When peripartum, wean off of warfarin and keep them just on LMWH
24 hours before delivery, stop LMWH
12 hours before delivery, start IV UFH
4-6 hours before neuraxial anesthesia, stop UFH
Post partum:
4 - 6 hours after delivery, start LMWH or UFH
5 - 7 days after delivery, start warfarin

9

Pregnancy LMWH anti-Xa target for mitral valve
For aortic valve

1.0 - 1.2 for mitral valve
0.8 - 1.0 for aortic valve