Is it reasonable to consider the use of DOACs for LV thrombus management instead of coumadin?
I have no qualms whatsoever at using a DOAC instead of Vitamin K antagonist in this situation, provided that the patient doesn't have a mechanical valve.
Endothelium is endothelium, so mechanistically I don't see much of a difference between using a DOAC to prevent/treat an LAA thrombus versus an LV...
You will not find a class I indication for using DOAC in LV thrombus because there is not likely to be a randomized, double-blinded clinical trial on this indication. The small number of patients involved will not provide enough quality data or incentive for the companies to apply for an additional ...
The current standard of care of LV thrombus is anticoagulation with warfarin. Use of DOACs for LV thrombi is an off-label indication and observational data has shown this to be inferior to warfarin. I would only consider DOAC in this situation for patients who refuse warfarin or cannot comply with t...