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Rivaroxaban in Patients With Atrial Fibrillation and a Bioprosthetic Mitral Valve

A large RCT with results somewhat supportive of considering a NOAC in the place of warfarin for post operative surgical patients. The study will be weighed against healthcare economical aspects. One question will arise:  Why,  if there was a subgroup ( the cohort had an average age below 60 years) eceiving lifelong warfarin or equivalent anticoagulation prior to surgery, they did not have a mechanical prosthesis?  It is of course possible that local financial constrains impede access to such devices, and bioprostheses were more affordable.  

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