Brief Answer:
I would explain as follows:

Detailed Answer:

Hello,

Regarding your concern, I would explain that when discussing about mechanical heart valves vitamin K antagonists (Warfarin), etc.) are the best choice with proven efficacy and safety profile.

New oral anticoagulants (like Eliquis) are actually not recommended in this regard (in prosthetic mechanical heart valves), because their efficacy has not been shown.

Coming to this point, I would advise continuing your current anticoagulant therapy with Warfarin paying special attention to regular INR test (every month) for properly managing its daily dose.

Hope to have been helpful to you!

In case of any further questions, feel free to ask me again.

Kind regards,

Dr. Iliri

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Brief Answer:
Opinion as follows:

Detailed Answer:

Hello,

Actually there are no clinical studies so far that confirm sufficient efficacy of Eliquis in preventing prosthetic valve thrombosis and systemic thromboembolism.

Sa, it may sound non-convenient having to poke your finger every month, but Warfarin has been shown the most effective at maintaining a functional mechanical valve and preventing serious complications.

Hope to have clarified your concern!

Regards,

Dr. Iliri

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Brief Answer:
I would explian:

Detailed Answer:
Hi!

Let me explain in simple words that the most serious and feared complications of mechanical valves are:

- valve thrombosis (when blood platelets aggregates on the valve leading to valve dysfunction and the need of valve replacement) and

- systemic thromboembolism (which is the case when a thrombus originating from the mechanical valve of a non properly anticoagulated patient migrates with the blood stream obstructing several smaller vessels in different parts of the body, like brain, intestine, limbs, etc.). This may lead to serious organ dysfunctions and damages like cerebral stroke, renal infarct, limbs gangrene, etc.

Warfarin is more effective in preventing such complications compared with Eliquis.

Hope to have been more clear to you!

Best wishes,

Dr. Iliri

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Brief Answer:
It is a worldwide recommendation.

Detailed Answer:
Current European and XXXXXXX clinical guidelines on valvular heart diseases confirm such a recommendation regarding vitamin K antagonists (Warfarin, etc.)

This conclusion is definitely clarified without any point of remaining doubt.

Regards,

Dr. Iliri

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Brief Answer:
It seems a rational alternative.

Detailed Answer:
I am afraid you should accept that compromise.

In case of any further questions, feel free to ask me again at any time.

Wishing you good health!

Dr. Iliri

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