The holy grail of anticoagulation in patients with intracardiac devices, such as mechanical heart valves (MHVs) and left ventricular assist devices (LVADs), comprises safe prevention of thrombosis without interrupting normal hemostasis. Device-induced thrombosis and anticoagulant-related bleeding problems are dreaded complications that may cause a significantly reduced quality of life and increased morbidity and mortality. Vitamin K antagonists are the current standard for oral anticoagulation therapy in patients with MHVs and LVADs. Even within the therapeutic range, hemorrhage is the primary complication of these drugs, which emphasizes the need for safer anticoagulants for the prevention of device-induced thrombosis. Device-induced thrombosis is a complex multifactorial phenomenon that likely requires anticoagulant therapy targeting multiple pathways. Here, we review the preclinical and clinical data describing the efficacy of a variety of anticoagulants as thromboprophylaxis after implantation of intracardiac devices.

心脏内装置（如机械心脏瓣膜（MHV）和左心室辅助装置（LVAD））患者抗凝的圣杯包括在不中断正常止血的情况下安全预防血栓形成。器械引起的血栓形成和与抗凝剂相关的出血问题是可怕的并发症，可能导致生活质量显着降低，发病率和死亡率增加。维生素 K 拮抗剂是目前 MHV 和 LVAD 患者口服抗凝治疗的标准。即使在治疗范围内，出血也是这些药物的主要并发症，这强调需要更安全的抗凝剂来预防装置诱发的血栓形成。器械诱发的血栓形成是一种复杂的多因素现象，可能需要针对多种途径的抗凝治疗。在这里，我们回顾了描述各种抗凝剂作为心内装置植入后血栓预防功效的临床前和临床数据。