Challenges of NOACs in Patients with Mechanical Heart Valves

The chapter analyzes the inefficacy of NOACs compared to warfarin for patients with mechanical heart valves, citing the Realign study. It discusses the pharmacokinetic and pharmacodynamic reasons behind the increased thrombotic and bleeding events in the intervention group. The chapter also explores the management of antithrombotic therapy post heart valve interventions, highlighting evidence gaps and the need for more trials.