Postoperative vitamin K antagonist exposure significantly increased the risk of structural valve deterioration (aHR 2.14) compared to non-users after bioprosthetic aortic valve replacement.
Cohort
No
Does postoperative Vitamin K antagonist exposure increase structural valve deterioration in patients with bioprosthetic aortic valves?
123 patients who underwent surgical bioprosthetic aortic valve replacement (AVR) between 2010 and 2025, mean age 71.3 years, 65% male.
Postoperative Vitamin K antagonist (VKA) exposure (cumulative use ≥3 months or time-varying).
No VKA exposure or cumulative use <3 months.
Development of structural valve deterioration (SVD) according to VARC-3 criteria.surrogate
Postoperative Vitamin K antagonist exposure and the use of porcine bioprostheses are independently associated with an increased risk of structural valve deterioration after surgical aortic valve replacement.
After bioprosthetic AVR, VKA exposure and porcine bioprostheses were independently associated with SVD. Antithrombotic strategies should consider the potential long-term adverse effects of VKA in the context of prosthesis material and patient characteristics. Prospective multicenter studies are needed to confirm these findings.
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Onur Barış Dayanır
Fatih Emre Kılıç
Ceren Sayarer
Turkish Journal of Thoracic and Cardiovascular Surgery
Dokuz Eylül University
Sivas State Hospital
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Dayanır et al. (Mon,) conducted a cohort in Bioprosthetic aortic valve replacement (n=123). Vitamin K antagonist (VKA) vs. Non-VKA (exposure <3 months) was evaluated on VARC-3-defined structural valve deterioration (SVD) (aHR 2.14, 95% CI 1.08-4.26, p=0.030). Postoperative vitamin K antagonist exposure significantly increased the risk of structural valve deterioration (aHR 2.14) compared to non-users after bioprosthetic aortic valve replacement.
www.synapsesocial.com/papers/69ba42ee4e9516ffd37a3ac4 — DOI: https://doi.org/10.4274/tjtcs.2026.28879