Prosthetic Heart Valves

• The choice of valve prosthesis depends on many factors including the patient, surgeon, cardiologist, and clinical scenario.

• With improvements in bioprosthetic valves, the recommendation for a mechanical valve in patients (fungi, staphylococcus), heart block/abscess, persistent infection.

• Surgery is also recommended for relapsing prosthetic valve endocarditis (Class I).²

• Those with large mobile vegetations of the native valve and recurrent emboli can be evaluated for early surgery (Class II).²

Figure 6-6 Anticoagulation management in pregnant patients with prosthetic valves.INR, international normalized ratio; LMWH, low molecular weight heparin,(Modified from Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary. A report of the American College of CardiologyAmerican Heart Association task force on practice guidelines. J Am Coll Cardiol. 2014;63:2438-2488. Copyright © 2014 American Heart Association, Inc., and the American College of Cardiology Foundation. With permission.)