Is It Safe and Effective to Reduce the Target Anticoagulation Range for Patients With Mechanical Prosthetic Aortic Valves?

Friday, May 29, 2020

Submitted by

Emily Robinson

Source

Source Name: Interactive CardioVascular and Thoracic Surgery

Source URL: https://doi.org/10.1093/icvts/ivaa028

Author(s)

Walid Mohamed, George Asimakopoulos

Mohamed and Asimakopoulos published a best evidence topic regarding the optimal INR target for patients with mechanical aortic valves. They analyzed a total of 922 studies and identified seven studies suitable for best evidence analysis. With regards to their results, a target INR below the standard INR target of 2-3 in patients without thrombogenic risk factors seems to be safe and did not increase the risk of thromboembolic events.

Comments

Submitted by Panagiotis Michail on Fri, 2020-05-29 18:36

Congratulations to both for bringing up the issue and researching the literature. I was heavily criticized in the past for maintaining my mAVR patients with an INR of no more than 2 post-op especially if they received a size 21 and up valve and had a good LV. In my 25 years of practice, I never had any problems with major bleeding or a malfunctioning valve. I hope this paper will convince and help CT surgeons in managing their patients anticoagulation in the future in a more efficient way.