Jagdish Butany, MBBS, MSc, FRCPC, Department of Pathology, Toronto General Hospital, University Health Network; Departments of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON.
Nasir A. Khan, BSc, Department of Pathology, Toronto General Hospital, University Health Network, Toronto, ON.
Sarah A. Erlich, BSc, Department of Pathology, Toronto General Hospital, University Health Network, Toronto, ON.
Anusha Jegatheeswaran, MD, Department of Cardiac Surgery, Toronto General Hospital, University Health Network, Toronto, ON.
Frances Budden, MD, FRCPC, Department of Geriatric Medicine, St. Joseph’s Health Centre, Toronto, ON.
Vivek Rao, MD, PhD, Department of Cardiac Surgery, Toronto General Hospital, University Health Network, Toronto; Department of Surgery, University of Toronto, Toronto, ON.

The incidence of valvular heart disease continues to increase, and the majority of individuals undergoing heart valve replacement today are older adults. Good postoperative management of these patients is critical and should include a complete history and thorough physical examination along with regular testing (typically including chest x-ray, echocardiogram, and blood tests) to carefully monitor heart function. Older adults are particularly at risk of bleeding and thromboembolic complications and, as such, compliance with anticoagulation and other medication should be closely monitored. Judicious attention to these issues will help minimize potential complications and improve survival in this patient population. This review discusses the postoperative management of older adults with a mechanical or a biological prosthetic heart valve.
Key words: heart valve replacement, prosthetic heart valves, older adults, anticoagulation, prosthetic valve endocarditis.