Therefore, we considered that this patient, without any anticoagulants, did not have thrombo-embolic complications due to the FX deficiency.Ĭardiac valve replacement is one of the most effective methods for the treatment of mid- to late-stage cardiac valvular diseases. We found that the patient suffered from factor X (FX) deficiency ( Table 2). Warfarin-related genes were tested ( Table 1). The preoperative PT and INR of this patient were 22.5 s and 2.02, respectively. There was no thrombosis in the heart valve or left atrium. On 29 September 2019, transthoracic echocardiography showed right ventricular enlargement ( Figure 2) and normal left ventricular function ( Figure 3), and the mitral valve was working well without any vegetation ( Videos 1 and 2). Repeat echocardiography showed a normal-functioning mechanical mitral prosthesis ( Figure 1). Follow-up interval for her will be half a year in the future. Interestingly, her INR had always remained in the range of 2.0–2.5 until now without any anticoagulants. Therefore, she had stopped taking warfarin and other anticoagulant treatments since she experienced excessive anticoagulation.
INR NORMAL RANGE MECHANICAL VALVE SKIN
We found that the patient had been taking 0.625 mg warfarin per day since one month after surgery, but due to excessive anticoagulation, she suffered from skin purpura without bleeding and neurological complications. The patient was discharged after symptoms of shortness of breath, leg swelling had been improved with diuretic therapy. At this time, she was admitted to our hospital again because of right ventricular dysfunction. She had a history of hypertension for 15 years. The patient underwent mechanical mitral valve (GK-3 tilting disc, 27 mm, made in China) replacement surgery on mid -June, 2007. Her abdomen was soft, non-distended, and non-tender, with normal bowel sounds and no organomegaly. Breath sounds were clear and symmetric bilaterally, without any crackles, wheezes, or rhonchi. A cardiovascular exam was significant for abnormal S1 and S2 but no murmurs or thrills on auscultation. A neck exam revealed no lymphadenopathy, jugular venous distention, or carotid bruits. On physical exam, her head exam revealed a normocephalic, atraumatic head with no palpable or visible masses. A patient's guide to taking warfarin.A 75-year-old Chinese woman was admitted to the hospital with symptoms of progressive oedema of the lower limbs. US Food & Drug Administration.Īmerican Heart Association. Highlights of Prescribing Information: Coumadin. Association Between Antithrombotic Medication Use After Bioprosthetic Aortic Valve Replacement and Outcomes in the Veterans Health Administration System. Usefulness and Safety of Rivaroxaban in Patients Following Isolated Mitral Valve Replacement With a Mechanical Prosthesis. Apixaban Versus Warfarin for Mechanical Heart Valve Thromboprophylaxis in a Swine Aortic Heterotopic Valve Model.
Rivaroxaban versus Warfarin in Patients with Mechanical Heart Valve: Rationale and Design of the RIWA Study. doi:10.1103/PhysRevFluids.4.123901ĭurães AR, de Souza Lima Bitar Y, Filho JAL, et al. Absolute instability of impinging leading edge vortices in a submodel of a bileaflet mechanical heart valve. Heart valve replacement: which type is best for you? American Academy of Family Physicians.Ĭleveland Clinic.
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