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Heart Disease (Expert Forum)
Correct INR for Patient with Mechanical Aortic Valve Replacement
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Correct INR for Patient with Mechanical Aortic Valve Replacement
by Ted, Nov 14, 1999 12:00AM
I am 31 years old. My aortic valve was replaced 11 weeks ago with a St. Jude mechanical valve. I believe that it was a size 25 or 27 St. Jude valve. My mitral valve was repaired (with a ring) at that time as well.
My surgeon recommended an INR range of 2.5 to 3.5 for the first 6-8 weeks and a range of 1.8-2.0 thereafter. My research (via internet) and the Coumadin package insert indicate that the appropriate INR range for patients with "mechanical" heart valves is 2.5 to 3.5. I asked my surgeon about the lower 1.8 to 2.0 range he recommended. He says that the most recent research indicates that the 1.8 to 2.0 range is acceptable for patients with "larger" St. Jude valves in the aortic position. Right now, 6 mg of Coumadin a day is keeping my INR right at 1.9 to 2.0.
Question: Is my surgeon correct? What do the docs at CCF recommend on this issue?
My surgeon recommended an INR range of 2.5 to 3.5 for the first 6-8 weeks and a range of 1.8-2.0 thereafter. My research (via internet) and the Coumadin package insert indicate that the appropriate INR range for patients with "mechanical" heart valves is 2.5 to 3.5. I asked my surgeon about the lower 1.8 to 2.0 range he recommended. He says that the most recent research indicates that the 1.8 to 2.0 range is acceptable for patients with "larger" St. Jude valves in the aortic position. Right now, 6 mg of Coumadin a day is keeping my INR right at 1.9 to 2.0.
Question: Is my surgeon correct? What do the docs at CCF recommend on this issue?
Doctor's Answer
by CCF CARDIO MD JMF, Nov 15, 1999 12:00AM
Dear Ted,
I have discussed this with our surgeons and we are unaware of this newer recommendation. It is our practice to have patients at least greater than 2.0 and more often between 2.5 and 3.5 as per national guidlelines.
I have discussed this with our surgeons and we are unaware of this newer recommendation. It is our practice to have patients at least greater than 2.0 and more often between 2.5 and 3.5 as per national guidlelines.
To Robert: Thanks and good luck on your upcoming surgery. Make sure you discuss all your options with your surgeon. A homograft is certainly an option you should consider.
I had a MVR replacment this year. The CCF doc is absoulty correct!!! Your INR should fall somewhere between 2.5 - 3.5 for your valve. Since it is Aortic they may beable to keep you on the low end of that range. I am not a doctor but I have done alot of reaserch. Please correct me if I am wrong. My doc wants to keep me on the mid to high end range of that scale 3.0 -3.5, becasue of the position for my mitral valve. With alot of playing around, and I mean alot. I just got regulated after 8 months on Coumadin. They think my daily dose is 6-1/2 mg. I am also eating a balanced diet including some greens. Everyone is different.
Wish you a speedy recovery.
Gina
***@****
Thanks a lot,
Janie
vitamin e
bilberry
flacseed oil
fish oil to name a few
mitch