caa a22 4500 475824407 CHVBK 20180406123827.0 cr unu---uuuuu 170329e20000801xx s 000 0 eng 10.1023/A:1018742620401 doi (NATIONALLICENCE)springer-10.1023/A:1018742620401 Mercadante Nicholas Health Alliance, Leominster Hospital, Leominster, Massachusetts aut Management of Patients with Prosthetic Heart Valves: Potential Impact of Valve Site, Clinical Characteristics, and Comorbidity [Elektronische Daten] [Nicholas Mercadante] Nearly four decades have passed since the first mechanical prosthetic aortic valve was placed. Since then several design changes and modifications have been made to improve longevity and hemodynamics and reduce thrombogenicity. Despite these advances thromboembolism remains the major problem for mechanical prosthetic valves. The type and the position of the prosthetic valve and several clinical characteristics such as age greater than 70, atrial fibrillation, depressed left ventricular systolic function, left atrial enlargement, left atrial thrombus and a prior history of systemic embolization influence the risk of thromboembolism and the level of anticoagulation needed to prevent this complication. Through clinical experience guidelines have been developed by the American College of Chest Physicians to determine the optimal level of anticoagulation needed to lower the thromboembolic rate with an acceptable hemorrhagic event rate. Kluwer Academic Publishers, 2000 Journal of Thrombosis and Thrombolysis Kluwer Academic Publishers 10/1(2000-08-01), 29-34 0929-5305 10:1<29 2000 10 11239 https://doi.org/10.1023/A:1018742620401 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1018742620401 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Mercadante Nicholas Health Alliance, Leominster Hospital, Leominster, Massachusetts aut NATIONALLICENCE 773 0- Journal of Thrombosis and Thrombolysis Kluwer Academic Publishers 10/1(2000-08-01), 29-34 0929-5305 10:1<29 2000 10 11239 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer