Rivaroxaban in Patients With Atrial Fibrillation and a Bioprosthetic Mitral Valve [1]
A large RCT with results somewhat supportive of considering a NOAC in the place of warfarin for post operative surgical patients. The study will be weighed against healthcare economical aspects. One question will arise: Why, if there was a subgroup ( the cohort had an average age below 60 years) eceiving lifelong warfarin or equivalent anticoagulation prior to surgery, they did not have a mechanical prosthesis? It is of course possible that local financial constrains impede access to such devices, and bioprostheses were more affordable.