International normalized ratio monitoring in post surgical patients with mechanical prosthetic valve: Our experience.

Dr. DHARMENDRA KUMAR SRIVASTAVA; Dr. BHUWAN TIWARI; Dr. SK VIJAY; Dr. SS RAJPUT; Dr. LATA KHATNANI; Dr.ANURAG RAI; Dr. SANDEEP KUMAR GAUTAM RAI

Volume : VII, Issue : II, February - 2017

International normalized ratio monitoring in post surgical patients with mechanical prosthetic valve: Our experience.

Dr. Dharmendra Kumar Srivastava, Dr. Bhuwan Tiwari, Dr. Sk Vijay, Dr. Ss Rajput, Dr. Lata Khatnani, Dr. Anurag Rai, Dr. Sandeep Kumar Gautam Rai

Abstract :

Although the need for oral anticoagulant therapy in patients with mechanical heart–valve prostheses is not in dispute, the optimal intensity of anticoagulation has been a matter of debate and is measured in International normalized ratio (INR) value. We followed 161 patients with mechanical prosthetic valve on oral anticoagulants from June 2012 to December 2016. We used ATS–Medtronic (77 cases), TTK Chitra Tilting Disc (71 cases) were most common mechanical heart valve implanted at mitral (65.2%), both aortic and mitral (21.72%) and aortic (13%) positions. In our study we also observed that fluctuations in INR monitoring in patients on oral anticoagulants commonly exists either in range or below range in respect to ACCP guidelines at any types and positions of implanted mechanical heart valve. The below range and in range INR value were at mitral (38.38%, 49.49%), at aortic (52.63%, 31.57%), at both aortic and mitral (55.17%, 37.93%) positions respectively. In our study we found that proper monitoring of INR during follow–up period and protocol based appropriate timely action taken can enable safe long term anticoagulation.