Figure 6. Anticoagulation for Prosthetic Valves
Prosthetic Valve
Mechanical valve
MVR
Bioprosthetic valve
MVR
AVR TAVR
Bridging anticoagulation
with UFH or SC LMWH
(I)
No bridging
additional
anticoagulation
needed
(I)
If VKA Rx interrupted for noncardiac
procedures, minimize time with
subtherapeutic INR
ASA 75-100 mg PO
QD
Longterm
(IIa)
Clopidogrel
75 mg QD
ASA 75-100
mg QD
First 6 mo
(IIb)
39
VKA INR
goal 2.5
First 3 mo
(IIa)
VKA INR
goal 2.5
First 3 mo
(IIb)
VKA INR goal 3.0
ASA 75-100 mg QD
Longterm
(I)
VKA INR goal
2.5
ASA 75-100 mg
QD Longterm
(I)
AVR
With risk
factors
AVR
No risk
factors
