The selection of antithrombotic agent should be individualized on the basis of patient risk factors (particularly risk for intracranial hemorrhage), cost, tolerability, patient preference, potential for drug interactions, and other clinical characteristics, including time INR is in therapeutic range for patients taking warfarin. New recommendation Closure of the left atrial appendage may be considered for high-risk patients with atrial fibrillation who are deemed unsuitable for anticoagulation if performed at a center with low rates of periprocedural complications and the patient can tolerate the risk of at least 45 d of postprocedural anticoagulation (Class IIb; Level of Evidence B). New recommendation Other cardiac conditions Anticoagulation is indicated in patients with mitral stenosis and a prior embolic event, even in sinus rhythm (Class I; Level of Evidence B). New recommendation Anticoagulation is indicated in patients with mitral stenosis and left atrial thrombus (Class I; Level of Evidence B). New recommendation Warfarin (target INR, 2.0 3.0) and low-dose aspirin are indicated after aortic valve replacement with bileaflet mechanical or current-generation, single-tilting-disk prostheses in patients with no risk factors* (Class I; Level of Evidence B); warfarin (target INR, 2.5 3.5) and low- dose aspirin are indicated in patients with mechanical aortic valve replacement and risk factors* (Class I; Level of Evidence B); and warfarin (target INR, 2.5 3.5) and low-dose aspirin are indicated after mitral valve replacement with any mechanical valve (Class I; Level of Evidence B). New recommendations Surgical excision is recommended for treatment of atrial myxomas (Class I; Level of Evidence C). New recommendation Table 5. 