Objective To compare the result of different anticoagulation methods after mechanical heart valve replacement in order to optimize the early-stage anticoagulation therapy. Methods Eighty-six patients with mechanical valve replacement were divided into four groups according to different anticoagulation methods, warfarin group 1 : warfarin was given from the 1st day after operation; warfarin group 2: warfarin was given from the 2nd day after operation; dipyridamole group: dipyridamole was given for two days from the 1st day after operation, and usage of warfarin from the 2nd day after operation ; fraxiparine group : fraxiparine was given for two days from the 1st day after operation, and warfarin was given from the 2nd day after operation. Complication and post-operative death were observed. The value of porthrombin time (PT), international normal ratio (INR), and blood clotting factor Ⅱ , Ⅶ etc. were monitored respectively at the day before operation, the day of operation and the 3rd, 5th day after operation. Results All the results of 4 groups have met the anticoagulation requirement on the 5th day after operation (INR 1.5-2. 0), and no hemorrhage, embolism and death occurred. In warfarin group 1, level of blood clotting factor Ⅱ , Ⅶ decreased, and level of PT, INR rose continuously, level of INR was 2.13±1.14 at the 5th day after operation, 1NR of 7 cases more than 2.0 in warfarin group 1 which was significant statistically compare with the other 3 groups(P〈0. 01). Conclusions To adopt warfarin with the maintainable dose from the 2nd day after mechanical valve replacement could simplify anticoagulation method, with no increased risk of post-operative complications, such as hemorrhage and embolism. There is no need for additional anticoagulation methods.
Citation: DIAO Ming qiang ,DONG Li,JIANG Hong,et al .. Methodological Study of Early Anticoagulation Following Mechanical Heart Valve Replacement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2006, 13(1): 10-13. doi: Copy