Anticoagulation in Patients with Mechanical Heart Valves
A 72 year old male with a past medical history of persistent atrial fibrillation and mitral and aortic mechanical valves presented for an elective left shoulder arthroplasty. Post-operatively, the orthopedic team was hesitant to resume anticoagulation immediately that resulted in a sub-therapeutic INR. Anticoagulation was resumed the day after surgery and bridged to warfarin. Anticoagulation in patients with mechanical heart valves is paramount due to the known risk of valve repair related thrombosis and thromboembolism. This case will highlight the importance of and review the guidelines regarding anticoagulation in patients with mechanical heart valves in the perioperative setting.
Parry N, Ahmed R, Maheshwari N, Khatoon T. Anticoagulation in patients with mechanical heart valves. Paper presented at: The American Society of Anesthesiology Annual Meeting; 2021 Oct 8-12; San Diego, CA. Available at: https://www.abstractsonline.com/pp8/#!/9323/presentation/5304