Recommendations

Document Overview

Design and created by Guideline Central in participation with the American College of Chest Physicians.

Antithrombotic And Thrombolytic Therapy For Valvular Disease

American College of Chest Physicians

Publication Date: Feb 1, 2012

Page Last Updated: May 5, 2026

Grading Recommendations

Grade	Description
1	Recommendation: indicates confidence that the benefits of the intervention clearly outweigh harms.
2	Suggestion: indicates greater uncertainty: although the benefits of the statement are still viewed as outweighing the harms, balance of benefits and harms is more difficult to judge, or the benefits or the harms may be less clear. With a suggestion, patient values and preferences may be more variable, and this can influence the clinical decision that is ultimately made.
Grade	Strength of Evidence
A	High: high confidence that the evidence reflects the true effect. Further research is very unlikely to change our confidence in the estimate of effect.
B	Moderate: moderate confidence that the evidence reflects the true effect. Further research may change our confidence in the estimate of effect and may change the estimate.
C	Low: low confidence that the evidence reflects the true effect. Further research is likely to change our confidence in the estimate of effect and is likely to change the estimate.

Document Overview

Document Title: Antithrombotic And Thrombolytic Therapy For Valvular Disease

Authoring Society: American College of Chest Physicians

Document Publication Date: Feb 1, 2012

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: journal.chestnet.org/article/S0012-3692(12)60132-9/fulltext

Source Citation: DOI: https://doi.org/10.1378/chest.11-2305

Document Scope, Criteria, and Use Cases

Document Objectives: Antithrombotic therapy in valvular disease is important to mitigate thromboembolism, but the hemorrhagic risk imposed must be considered. These antithrombotic guidelines provide recommendations based on the optimal balance of thrombotic and hemorrhagic risk.

Scope: Management, Prevention, Treatment

Diseases/Conditions (MeSH)

D000991 - Antithrombins

D015912 - Thrombolytic Therapy

D000925 - Anticoagulants

D006349 - Heart Valve Diseases

D006470 - Hemorrhage

D000925 - Anticoagulants

D015912 - Thrombolytic Therapy

D000991 - Antithrombins

D006349 - Heart Valve Diseases

D006470 - Hemorrhage

Keywords: Antithrombotic Agents, anticoagulation, hemorrhage, thrombolytic agents, valvular heart disease

Target Patient Population: Patients with thromboembolism associated with valvular heart disease

Inclusion Criteria: Female, Male, Adolescent, Adult, Older Adult

Health Care Settings: Ambulatory, Emergency Care, Hospital, Operating and Recovery Room, Outpatient, Radiology Services

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Data Supplement

Number of Source Documents: 135

Literature Search Start Date: Saturday, January 1, 2005

Literature Search End Date: Thursday, October 1, 2009

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Antithrombotic And Thrombolytic Therapy For Valvular Disease

Recommendations

Rheumatic Mitral Valve Disease

Aortic Atheroma and Patent Foramen Ovale

Endocarditis

Bioprosthetic Heart Valves

Mechanical Heart Valves

Heart Valve Repair

Prosthetic Valve Thrombosis

Grading Recommendations

Document Overview

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology