Strategy of warfarin adjustment after mechanical heart valve replacement

Objective:To study the strategy of warfarin anticoagulation and the relationship between age,gender,body weight and the amount,efficacy of warfarin,after mechanical heart valve replacement.Methods:All the 192 patients who had undergone valve replacement in our hospital were involved in this study.Sum the method of warfarin anticoagulation to adjust the international normalized ratio(INR).Analysis the clinical data of age,gender,body weight,warfarin dose and its INR,and observe its anticoagulant effects and major adverse events.Results:One case of death was due to intracranial hemorrhage using overdose of warfarin,1 case of complication was due to excessive subcutaneous bleeding and severe nasal bleeding,1 patient had lacunar brain stem,2 patients were ineffective using of warfarin alone,but after combination with aspirin the INR could adjust to the target range.Rest of the patients had a good result,with no serious bleeding and thrombosis.Conclusion:There was great individual difference in the doses and coagulation effects of warfarin,independent with age,gender and body weight.To maintain INR at 1.8 to 2.5 is appropriate,which does not increase the risk of bleeding and thrombosis.