The most common anticoagulation drug prescribed after heart valve surgery is warfarin (Coumadin). The newer blood thinners are apixaban and dabigatran, also known as Pradaxa and are expensive. The main concern is that specific antidotes for bleeding are available for warfarin but not yet developed for the new drugs.
I have the same history you do, of valve surgery and post-surgical HIT. You can take warfarin with a history of HIT. If you happen to have a mechanical valve, I'm sure you already are taking warfarin. If you're on warfarin, and you're wondering what to use for bridging, that would be Arixtra (fondaparinux). Fondaparinux is dispensed in syringes for subcutaneous injection, to be self-administered once a day. I've used it, and it's easy. It's covered by most health insurance policies that have a prescription drug benefit, especially since the generic came on the market a couple of years ago. Besides warfarin and fondaparinux, the only other "blood thinner" that I know of that can be used by someone with a mechanical heart valve and a history of HIT is argotroban, but that is an IV- administered drug. I was given argotroban in the hospital. Apixiban and dabigitran are nonapproved for mechanical heart valve patients.
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