Prosthetic heart valves Flashcards
What is used for biological (bioprosthetic) valve replacement?
Bovine or porcine
What is the most common mechanical valve used?
Bileaflet valve
(ball and cage now rarely used)
What is the major disadvantage of biological valves?
Structural deterioration + calcification
May require future replacement, posing additional risks
What is the major advantage of biological valves?
Lower risk thrombogenesis
Long term anticoagulation not usually needed
Warfarin maybe given for first 3 months depending on patient factors
Describe the use of aspirin in biological valves
Low dose aspirin given longterm
In which patient group are biological valves preferred?
> 65s for aortic valves
70s for mitral valves
What is the main advantage of mechanical valves?
Greater longevity +
low failure rate
What is the major disadvantage of mechanical valves?
Increased risk of thrombosis meaning long term anticoagulation is needed
What is the preferred form of anticoagulation for patients with mechanical heart valves?
Warfarin
What is the target INR for aortic and mitral mechanical valves?
Aortic: 3.0
Mitral: 3.5
Describe the use of aspirin in mechanical valves
Only given if additional indication e.g. IHD
What are the guideline regarding prophylaxis of endocarditis in patients with valve replacements?
No abx recommended for common procedures
