Selection criteria
We included all women patients undergoing MVR at our center from January 2010 to February 2020. We also included patients who underwent MVR with atrial fibrillation (AF) ablation and tricuspid valve repair or replacement. Age, sinus rhythm, and lifestyle were considered as a recommendation for MBP. Women who desired to become pregnant, for whom oral anticoagulants were contraindicated, and who showed poor anticoagulant compliance were also considered for MBP, even if they were < 60 years old. Our exclusion criteria were infective endocarditis, prior cardiac operation, cardiogenic shock, emergency operation, and concomitant coronary artery bypass graft or aortic valve replacement. All patients with MBP received oral acetylsalicylic acid at 150 mg daily only for the first 3-6months, while those with MMP +/- AF regularly received daily oral anticoagulants such as coumadin (warfarin®, Bristol-Myers Squibb, Egypt).