Outcomes of Warfarin Therapy for Bioprosthetic Valve Thrombosis of Surgically Implanted Valves

In this manuscript, the authors describe their findings in an observational prospective study of 52 patients who had tentative diagnoses of bioprosthetic valve thrombosis (BPVT) of surgically implanted valves over a 3-year period. All patients underwent a trial of anticoagulation therapy with warfarin, and follow-up transthoracic or transesophageal echocardiography performed at least 4 weeks after the initiation of anticoagulation therapy. The authors found that an echocardiographic diagnostic score predicted the response to warfarin anticoagulation in BPVT with excellent accuracy, that warfarin significantly reduced prosthetic gradients in 83% of the patients; and that this diagnostic and therapeutic strategy was associated with minimal side effects and no mortality.