The clinical study of oral warfarin therapy after mechanical valve implantation

Objective To inquire into the suitable dose of warfarin for patients with mechanic valve replacement. Methods From July 2003 to April 2006,113 patients were accepted mechanical valve implantation. Warfarin therapy was given at the second day after operation. The first oral dose of warfarin was 3 mg/d for all patients. International normalized ratio (INR) was monitored according to the postoperative anticoagulation protocol during the follow-up. The value of INR was keep at 1.8 to 2.6. Anticoagulation related event included hemorrhage, Thromboembolism and death incidence. Results There was no hospital death. There were four deaths during follow-up (3.54%). One case had brine bleeding (0.09%). Urinary tract bleeding was in one case(0.09%). The incidence of anticoagulation related event was simulated to the data in the up date literature. The value of INR was continuatively increased the first four days after operation. There were not relationship between the complication related anticoagulation and the patient's age or weight excepted the hepatic function of patients. Conclusion The oral dose of warfarin was regulated with individuate to keep INR at 1.8 to 2.6,which was relative safety and provided satisfactory results of anticoagulation therapy.