What antithrombotic therapy is recommended for patients with mechanical prosthetic heart valves?
Anticoagulation with warfarin to achieve an INR of 2.5 is typically recommended for patients with a mechanical bileaflet or current-generation single-tilting-disk aortic valve replacement and no risk factors for thromboembolism. Patients with an aortic mechanical prosthesis who have a history of ischemic stroke or TIA are at higher risk of thromboembolic complications, and it is recommended to maintain the INR at a higher target of 3.0 (range, 2.5 3.5) or to add aspirin 75.