Reply to Güner et al.—Management of Obstructive Heart Valve Thrombosis: Differences Between Biological and Mechanical Prostheses

We have read carefully the letter to editor by Güner et al.,1Güner A. Kalç?k M. Kalkan S. al.Management of obstructive prosthetic heart valve thrombosis: thrombolytic therapy or anticoagulation?.Can J Cardiol. 2021; 37: 938.e7Abstract Full Text PDF Scopus (1) Google Scholar in which we were urged clarify certain aspects related case report that published about thrombosis a bioprosthesis COVID-19.2Llopis Gisbert G. Urrutia V.V. Moruno Benita M.A. al.Bioprosthetic and obstruction secondary COVID-19.Can 938.e3-938.e6Abstract (2) In first instance, want thank authors for interest shown our article, hope reading it has been useful. describe diagnosis process bioprosthetic patient with COVID-19 explain management achieve satisfactory resolution. quoted letter, wonder why selected treatment was anticoagulation instead (TT) surgery. According authors, these treatments are line (PVT), providing studies strong scientific evidence support it. agree statement; fact, is use centre cases PVT. The point article biological heart-valve prostheses, all they mechanical prostheses. recommended clearly differs. It true there less compared prostheses because common, only few studies. However, main first-line should be not TT For example, 2020 American College Cardiology/American Heart Association clinical practice guidelines,3Otto C.M. Nishimura R.A. Bonow R.O. al.2020 ACC/AHA guideline patients valvular disease: Joint Committee on Clinical Practice Guidelines.Circulation. 143: e72-e227PubMed vitamin K antagonists indicated as treatment, class recommendation 2b level B-NR (as based small nonrandomized studies). More overwhelming European Society Cardiology 2017 guidelines, recommend A unfractionated heparin I-C.4Baumgartner H. Falk V. Bax J. al.2017 ESC/EACTS guidelines disease.Eur 2017; 38: 2739-2791Crossref PubMed conclusion, publications provided but ones. aware weak, still widely