Warfarin post surgery with a tissue valve? Pros and Cons?

[Iang]

Hello,

I have been told different things about being prescribed Warfarin (Coumadin) post surgery with a tissue valve. This is for otherwise healthy patients who have no other issue beside having AVR.

I have heard some doctors who have an "older way" of thinking prescribe it for 3 months even though it is truly not necessary. I have heard others prescribe daily aspirin for 3 months. And others prescribe nothing.

I recently heard there is very new research that suggest taking Warfarin for 3 months may give time for a tissue valve to heal and can eventually lead to greater longevity for a tissue valve. Which, of course, is an excellent benefit.

Does anyone know about best practices in this area or has heard about the latest research?

Thank you!

 

[pellicle]

I have heard some doctors who have an "older way" of thinking prescribe it for 3 months even though it is truly not necessary.

Well then, if it's truly not necessary you have it covered.

What's the negatives as you see it?

Or is jt just boogy man under the bed?

Look up paravalvula leak and endthelization.

Myself I would prefer to take the precautionary approach and take it. Who knows, surgeons may just know more than you or I

Is your fear of warfarin what drove your valve choice?

Some reading, try Google too

[h=2]Clinical bottom line[/h]
Patients post-bioprosthetic MVR should have warfarin for 3 months with an INR of 2–3. For patients post-bioprosthetic AVR without additional risk factors, antiplatelet therapy alone is adequate.

https://academic.oup.com/icvts/artic...cribed-for-the

 

[epstns]

I guess I had some additional risk factors. . . I was prescribed warfarin for 3 months post AVR (tissue valve). At the time (6 years ago) this was the standard of care at the hospital where my valve was replaced. It may be different now.

I suppose it did give me some added protection, too, as I had some afib during those first few months, and they usually prescribe warfarin for afib patients.

It truly was not a big deal, other than getting my INR stabilized in the therapeutic range. I ignored the nurse's diet instructions, instead taking my old (late) friend Ross Young's advice of "Dose the diet, don't diet to the dose."

 

[pellicle]

...instead taking my old (late) friend Ross Young's advice of "Dose the diet, don't diet to the dose."

(quiet moment observed for Ross)

 

[neil]

I was prescribed heparin for first 3 months after tissue valve, no problem, your correct different cardios prefer different things, good luck

 

[neil]

I was prescribed heparin for first 3 months after tissue valve, no problem, your correct different cardios prefer different things, good luck