ProstheticHeartValves in afya

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most common valves to replace - aortic and mitral
either biological (bioprosthetic) or mechanical.

''Biological (bioprosthetic) valves''	
Usually bovine or porcine in origin
Major disadvantage - structural deterioration and calcification over time.
older patients ( > 65y aortic, > 70y mitral) receive a bioprosthetic valve
Long-term anticoagulation not usually needed. 
Warfarin for first 3/12 then Low-dose aspirin

''Mechanical valves''
most common - bileaflet valve. 
Ball-and-cage valves are rarely used nowadays
Mechanical valves have a low failure rate
Major disadvantage - increased risk of thrombosis meaning long-term anticoagulation 
Aspirin as well unless contraindication.
Target INR - aortic: 2.0-3.0, mitral: 2.5-3.5

2008 NICE guidelines for prophylaxis of endocarditis - antibiotics not needed for common procedures eg dental

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