aortic vs. mitral-coumadin

[mile high]

Hello all,

In visiting my cardio recently and discussing the coumadin regimen for a colonoscopy he indicated that there is less concern in regards to low INR's for those who have mechanical aortic valves versus those with mechanical mitral valves. This came up in context of going off of coumadin for a few days prior to the procedure. This meant that those with mitral valves replaced there is a larger concern for stroke with low INR's than those with mechanical aortic valves

Has anyone viewed any research or articles concerning this?

Thanks

Mile High

 

[Nancy]

Yes, I have heard this. It is also a concern for those with double or more replacements who should be on a higher INR on a regular basis.

By the way, I have found that many, many doctors and other medical professionals don't know the recommended INR level is for the various conditions, i.e. double valve replacements, those with afib or aflutter, etc.

You would do well to remind your doctor, no matter what their professional expertise, if you are on a higher INR level. Even some doctors within the cardiology field either didn't know that Joe needed to be on a higher INR , or they didn't read the chart showing he has a double valve replacement. It always shocks me when I find out that this is the case. I just automatically remind every doctor of the higher INR right at the beginning and every time there is any kind of med change or procedure.

I guess sometimes, there is just too much information to process.

 

[Guest]

There is a higher pressure blood flow through the aortic valve, so there is less concern of clotting. The mitral flow is more sluggish, so clots are more likely to form from stagnation. Having both valves is a major concern when warfarin has to be stopped.

 

[mile high]

Thanks Nancy and Al for your responses. While I could not remember when I asked the question, Al's comment on higher presssure blood flow thru the aortic valve is what my cardio did mention as the reason for less concern with lower INR's and clotting. Nancy, your comment is quite interesting and something I have not seen posted before (altho I read alot less posts than you do probably). The fact that alot of doctors do no know this seems to follow a similar theme thruout this site, that is doctors knowing less than we do. We must always be vigilant in knowing our situations and making sure the doctors understand some of these things.

Thanks again.