Investigation of reasonable warfarin anticoagulation therapy in open heart valve replacement with radiofrequency ablation

Objective To investigate the therapy of reasonable warfarin anticoagulation in heart valve replacement with radiofrequency ablation.Methods 130 cases of valvular heart disease with atrial fibrillation in patients were divided into 2 groups according to treatment.The general information of two groups was no significant difference.Pateints in group A(n=60) were given heart valve replacement with radiofrequency ablation,took amiodarone 6 month and warfarin anticoagulant therapy together after operation;Patients in group B(n=70) were given the only separate valve replacement surgery,took only warfarin anticoagulant therapy.Two groups were used low-intensity anticoagulation standard in INR values 1.5~2.5 and observed between the anticoagulant effect and warfarin anticoagulant dose.Results Patients were followed up for 3 to 16 months,and 1 died,1 lost in group A;1 died in group B.There were not anticoagulant-related deaths.Group A caused mild bleeding 5 cases,severe bleeding 0 cases,thromboembolism 0 cases,abnormal elevation of the INR value(INR4) 4 cases.Group B caused cases of 3,0,3,1.To compare these values in the two groups,P0.05.When anticoagulant steady state was reached in the group A,the warfarin dose of mitral valve replacement was(2.31±0.87) mg/d,aortic valve replacement was 3.125 mg/d,the double valve replacement was(2.74±0.44) mg/d.The warfarin dose in group B were(2.59±0.75),(3.47±0.44),(2.78±0.90)mg/d.To compare these values in the two groups,P0.05.When anticoagulant steady state was reached in the group A,the comparison histogram between dose of warfarin and the number of patients showed that dose of warfarin was(2.43±0.58) mg/d,the comparison histogram between the ratio INR and the number of patients showed INR was 1.83±0.55.Conclusion The low-intensity anticoagulation standard of INR values 1.5~2.5 and got satisfied anticoagulant effect for the patients who finished the operation of valve replacement with radiofrequency ablation.But anticoagulation monitoring should be strengthened in the heart valve replacement patients because of taking amiodarone.To avoid bleeding,we should reduce appropriatly the dose of warfarin according to the anticoagulant INR results.