what is proper inr range for avr?

[Megan]

hello everyone! sorry ive been MIA for a few weeks.. these kiddos on summer breaK are keeping me too busy and too crazy to find a moments peace! i must have read something wrong because I thought a normal range for my new valve-ATS- was 2.5-3.5 but it turns out it should be in the 2.0 range so says my cardio...just wanted to see what other people's ranges are for an avr..and also what is the standard time between tests-is it 2 weeks? thanks!
megan

 

[kpearse]

Hi Megan, I also have an ats aortic valve and my range is 2.5-3.5. I get tested every 6 to 7 weeks. Hope this helps.

 

[Bina]

Half the people on here will say 2.0---3.0
the other half will say 2.5---3.5 (my range)
It's hard to be exact, so we like to stay between 2.0----4.0 (for AVR with no other problems)

 

[KristyW]

Megan,

The "Standards" are

Mechanical Aortic Valve with no other mitigating circumstances 2.0-3.0
Mechanical Mitral Valve 2.5-3.5
Double Mechanical Valves 2.5-3.5, some are told 3.0-4.0.

I know that many of us (me included) figure between 2.0 and 4.0 is good enough. Of course we almost all fight our coumadin managers on this. I know that mine has finally ceded that I'm not going to do anything if it's under 4.0 other than come back in a week to 10 days to recheck.

Try not to let them bully you. Eat what you want, be consistent with taking your meds, and test regularly. If your managers are adjusting your dose for a 3.6....run, they don't know what they're doing.

 

[Bina]

With a home tester I test every 2 weeks. Otherwise at the lab it was monthly.
(providing INR is in range.)

 

[Ross]

Megan,

The "Standards" are

Mechanical Aortic Valve with no other mitigating circumstances 2.0-3.0
Mechanical Mitral Valve 2.5-3.5
Double Mechanical Valves 2.5-3.5, some are told 3.0-4.0.

I know that many of us (me included) figure between 2.0 and 4.0 is good enough. Of course we almost all fight our coumadin managers on this. I know that mine has finally ceded that I'm not going to do anything if it's under 4.0 other than come back in a week to 10 days to recheck.

Try not to let them bully you. Eat what you want, be consistent with taking your meds, and test regularly. If your managers are adjusting your dose for a 3.6....run, they don't know what they're doing.

This is spot on.

We see so much misinformation from the medical community being circulated repeatedly, that if you have questions, your better off asking the people taking the drug, then you are those that manage it. They fear bleeding, we fear stroking out. You can replace blood cells, you cannot replace brain cells.

 

[terodac]

Both my doctors want 2.5-3.5 range, Cardio would like it 3.0 - 3.5 which is hard to do! I am happy at 2.7-3.3! My NP that was handling this is a nutt, I found out real quick she does not know what she is talking about. Noticed the other day they had a EXPERT handling this now, I ran the other way!! Listened to her talk to a patient explaning why he had to take it, never did answer the poor mans question.

 

[Rich]

I have a mechanical St. Jude aortic valve.
My range has always been 2.5 to 3.5 and with many years experience that's the way I like it.
I am well aware of the standard range for an AVR, but I'm not comfortable with it and neither is my cardio.
If I get a little low I'm usuallly still above 2.0. Using 2.0 to 3.0 if I was to get a bit low, then I might be below 2.0 and to me that is dangerous ground.
My wife's sister had a major stroke and died because she was well below 2.0.
So I will stick with 2.5 to 3.5.
As far as testing at the lab it has always been monthly unless there is a problem.
As has been mentioned only you know best what has been going on in your lifestyle. This includes diet, medication, and activity level changes.
So my suggestion is stick with the real experts right here on this site.

 

[Natanni]

Hello! You may want to consider verifying once more with your cardiologist what your INR range should be. My husband started out with an INR range 2.5 - 3.5. At his 2 year post op check up, it was changed to 2.0 - 3.0 in view of his heart improvement and the generation valve that was used. INR ranges are patient specific, so it is something you might want to clarify with your person doc. Best wishes

 

[Mentu]

One of our compartriots, Catwoman, offered this website which contains video clips of 3 Doctors involved in managing anticoagulation discussing this:

Discovery Health (CME) Anticoagulation Film:

http://discoveryhealthcme.discovery.com/beyond/miniPlayer.html?playerId=1225901422

 

[Jackie]

2.5 - 3.5 I had and AVR

 

[acr]

Sounds good, that's my target range. Got 2.4 on the last test, grrr

 

[Woodbutcher]

This is the place for inr advise without question. Every Cardio expert or Dr or Warfarin clinic nurse expert I've dealt with so far has given me wildly differing advise. Infact one Cardio told told me there's no way I should be under 4.0 !! I politely told him he really needed to study his subject some more before consulting and left his practice.
Like most others here I'm happy between 2.0 and 4.0 and so far have been constantly between 2.3 and 2.9, doing as I please and eating as I please.
There will of course be exceptions to this rule, with differing medical histories or contributing health conditions.

 

[sue943]

My range was prescribed by the cardiac surgeon who operated on me - I am happy with that.

 

[Megan]

thanks everyone- im going to print out these replys and take it with me to a ll my drs!

 

[Ross]

Megan please understand that what KristyW posted are the Guidelines, but only that. There has never been anything set in stone on what your range should be. They leave that up to the Doctors decision, but I can tell you this, there have been published studies stating that there is no advantage to being 4.0 or higher. A normal persons blood begins to clot in about 10 seconds. One on anticoagulation can be from 20 to 35 seconds.

 

[olefin]

Mechanical Aortic Valve range is 2.5 to 3.5.

I've only had two different cardiologist over the 18 years and they agree to that control range. Must be correct for it's worked with no problems.

I don't like to see it below 2.5.

 

[BigOwl]

All my research indicates that 2.0-3.0 and 2.5-3.5 are common under a variety of circumstances. Mine is 2.5-3.5 with a mechanical valve with no complications. My clinic (I'm still being tested every two weeks four months post-op) is happy with 2.3-3.5; I've maintained 2.5-2.7 now for several weeks and after 3 months of therapeutic ranges I can get a monitor and not have to drive the 30 miles there and 30 miles back again. Whoopee!

Just remember that in the US and with different valves the ranges vary, and in Europe they're typically a little lower. Risk factors change the picture, so be sure you know what yours are.

 

[Cooker]

I would always like to be on the high side ... for my peace of mind ... If I am between 2.5 and 4.5 I'm happy ....

 

[sweetmarie]

In preparation for upcoming carpet tunnel syndrome surgery June 13th, I met with an internal medicine md to set up a bridging plan (stopping Coumadin and initiating Fragmin injections). The range my heart surgeon set up for me when I left the hospital upon my release from my OHS was 2.0-3.0 and this is what I've been following since. The md I met was quite adamant in letting me know that I should be at 2.5-3.5 and without a doubt in his mind. I told him that 2.0-3.0 was what the surgeon decided and he more or less said that he was wrong. I'm a little confused as his instructions following my surgery is to aim for 2.5-3.5, different from what my heart surgeon implemented.
I'm going to call my surgeon's office for consultation. I realize that 2.0-3.5 is still a comfortable and safe range but all the dosing protocols are based on 1.0 spans, not 1.5.