OPTIMAL INR RANGES IN PATIENTS WITH PROSTHETIC HEART VALVES

Abstract

Prothrombin time (PI) is the most common method used for monitoring oral anticoagulant therapy. The problem of erratic anticoagulant control has been largely solved by the introduction of a standardized method of PT reporting which has been adopted by the WorId Health Organization, and standardized PT. reporting by converting PT ratio observed with any local thromboplastin into INR Oral anticoagulants are employed very frequently in patients with prosthetic valves. Our objective was to maintain the optimal therapeutic range of INR for patients who undergo heart valve repair or replacement with prosthetic valve, by considering the level of anticoagulant therapy. One hundred and sixty-two patients were operated on for isolated aortic (n=39), mitral (n=67), aortic plus mitral (n=23) valve replacement and valve repair (n=33). The mean ± SD of age and weight for all the patients was 39.01 ± 2,14 year and 63.83 ± 10.05 kg. These results showed that 69.23 % of the patients were stabilized in their expected INR range. We recommend to stabilize patients between INR 2.0 to 2.5 if operated for valve repair, 2.5 to 3.0 if operated for aortic valve replacement and 3.0 to 3.5 if operated for mitral or both aortic and mitral valve replacements.