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Mechanical valves will last the lifetime of the patient, which decreases a patient’s risk of reoperation, but are associated with an increased risk of thromboembolic and bleeding events compared with bioprosthetic valves because of the need for lifelong anticoagulation.
received an average of 6.4 (SD = 3.5) doses of warfarin before discharge. The mean length of stay was 8.3 (SD = 3.5) days in the hospital. The mean (SD) PT on the day of discharge was 25.4 (4.4) seconds, and the mean (SD) INR was 2.4 (0.4) (therapeutic goal = 2.5–3.5). This group had no postoperative complications of bleeding or death but did experience stroke (15.4%), hemorrhage (15.4%), and supratherapeutic INR (7.7%; Table 3).
Discussion Although the data did not support the hypothesis in all patients who require mechanical valve replacement, there was a statistically significant association between patients’ preoperative prothrombin times and length of hospital stay in the aortic valve replacement group. There are several explanations for this finding: lack of representativeness of the sample, complication rates, and differences in the therapeutic INR levels between the types of valves.
Mechanical aortic valve replacement requires a lower therapeutic INR level postoperatively compared with mitral valve replacement and both (aortic and mitral) valve replacements. The therapeutic INR level is 2–3 for mechanical aortic valves and 2.5–3.5 for mechanical mitral valves.10 Other studies have found that postoperative complications rates can increase length of stay.15-18 This can be a factor that ultimately affected the final results. There are several limitations to
Clinical Care of the
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