To Treat or Not to Treat? The Real Question on Anticoagulation After Mitral Repair Remains Unanswered.

In this issue of The Annals of Thoracic Surgery, Mazur and colleagues 1 Mazur P.K. Arghami A. Macielak S.A. et al. Apixaban for anticoagulation after robotic mitral valve repair. Ann Thorac Surg. 2023; 115: 966-974 Abstract Full Text Full Text PDF Scopus (1) Google Scholar examined 626 patients undergoing robotic-assisted mitral valve (MV) repair for outcome differences between patients receiving 6 weeks of postoperative oral anticoagulation (OAC) prophylaxis with warfarin (n = 499) vs apixaban (n = 127). They found no difference in a 3-year composite outcome of death, stroke, bleeding, or thromboembolic events, leading them to logically posit that apixaban was equivalent to warfarin for postoperative prophylaxis after robotic MV repair. Our Mayo colleagues 1 Mazur P.K. Arghami A. Macielak S.A. et al. Apixaban for anticoagulation after robotic mitral valve repair. Ann Thorac Surg. 2023; 115: 966-974 Abstract Full Text Full Text PDF Scopus (1) Google Scholar deserve our thanks for a detailed analysis with a data-driven conclusion. However, the larger issue not answered by this study is the primary benefit of OAC over aspirin alone. Apixaban for Anticoagulation After Robotic Mitral Valve RepairThe Annals of Thoracic SurgeryVol. 115Issue 4PreviewThere is no consensus regarding postoperative anticoagulation after mitral valve repair (MVRep). We compared the outcomes of post-MVRep anticoagulation with apixaban compared to warfarin. Full-Text PDF