Abstract

Thromboembolic and anticoagulation related bleeding problems remain one of the most frequent complications of cardiac valvular prosthesis. Which and how much drug dose should be given depends on the individual response to the drug and the complications thereof. The aim of the study was to know the outcome of patients taking Acenocoumarol as anticoagulant drugs in prosthetic heart valves. The study was conducted on the patients who were on Acenocoumarol after heart valve replacement, and the dose was adjusted as per international normalized ratio (INR). Most of the patients were in the 4th decade of life and males were more. Seventy-three had mitral, 19 aortic, and 3 double valve replacements done. Medtronic Hall valve was the common prosthesis used in 78, followed by Bjork Shilley in 17. Acenocoumarol was the drug used in all. Seven patients developed central nervous system events, 6 patients had features of peripheral embolization of which two had surgical intervention done, two needed amputation. Complications occurred more in patients with mitral prosthesis, and were less in patients who maintained an acceptable INR of 2.5 to 3.5. Meticulous surgery, uneventful post-operative period, early anticoagulation, and maintaining an ideal INR are the gold standards in preventing thromboembolic and bleeding complications after valve replacement.

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