5
Table 11. Other Cardiac Conditions
Recommendations
COR LOE
Anticoagulation is indicated in patients with mitral stenosis and a
prior embolic event, even in sinus rhythm.
I B
Anticoagulation is indicated in patients with mitral stenosis and le
atrial thrombus.
I B
Warfarin (target INR, 2.0-3.0) and low-dose aspirin are indicated
aer aortic valve replacement with bileaflet mechanical or current-
generation, single-tilting-disk prostheses in patients with no risk
factors.
a
Warfarin (target INR, 2.5-3.5) and low-dose aspirin are
indicated in patients with mechanical aortic valve replacement and
risk factors
a
; and warfarin (target INR, 2.5-3.5) and low-dose aspirin
are indicated aer mitral valve replacement with any mechanical
valve.
I B
Surgical excision is recommended for the treatment of atrial
myxomas.
I C
Surgical intervention is recommended for symptomatic
fibroelastomas and for fibroelastomas that are >1 cm or appear
mobile, even if asymptomatic.
I C
Aspirin is reasonable aer aortic or mitral valve replacement with a
bioprosthesis.
IIa B
It is reasonable to give warfarin to achieve an INR of 2.0-3.0 during
the first 3 months aer aortic or mitral valve replacement with a
bioprosthesis.
IIa C
Anticoagulants or antiplatelet agents are reasonable for patients with
heart failure who do not have AF or a previous thromboembolic
event.
IIa A
Vitamin K antagonist therapy is reasonable for patients with STEMI
and asymptomatic le ventricular mural thrombi.
IIa C
Anticoagulation may be considered for asymptomatic patients
with severe mitral stenosis and le atrial dimension ≥55 mm by
echocardiography.
IIb B
Anticoagulation may be considered for patients with severe mitral
stenosis, an enlarged le atrium, and spontaneous contrast on
echocardiography.
IIb C
Anticoagulant therapy may be considered for patients with STEMI
and anterior apical akinesis or dyskinesis.
IIb C
Antithrombotic treatment and catheter-based closure are NOT
recommended in patients with PFO for primary prevention of stroke.
III C
a
Risk factors include AF, previous thromboembolism, le ventricular dysfunction, and
hypercoagulable condition.
