Edoxaban Dose Reduction Criteria — EECC MCQ

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HardCardiac PharmacologyEdoxaban Dose Reduction CriteriaEECC

A patient with a mechanical aortic valve has obstructive valve thrombosis, pulmonary oedema and shock. Surgical risk is acceptable and an experienced surgical team is immediately available. What is the preferred treatment?

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Correct answer: A — Urgent valve surgery

Critically ill patients with obstructive mechanical prosthetic thrombosis require immediate Heart Team action. Emergency surgery is generally preferred when available and operative risk is acceptable; fibrinolysis is an alternative in selected circumstances such as prohibitive surgical risk or lack of access. Simply intensifying oral anticoagulation is inadequate in shock. Apply this conclusion only to the clinical circumstances stated, with appropriate specialist review, contraindication checks, shared decision-making and follow-up. Reassess if the physiology, treatment response or competing risk changes. The competing options would require a different haemodynamic profile, diagnosis, procedural indication or risk balance from the one described here.

Reference: 2025 ESC/EACTS Guidelines for valvular heart disease. https://www.escardio.org/guidelines/clinical-practice-guidelines/valvular-heart-disease/