Anticoagulant Treatment In Patients With Mechanical Heart Valve: A Clinical Analysis Of 9 Cases Of Cerebral Embolism And Review Of Literature

Background and objective:Anticoagulant therapy is needed after mechanical heart valve replacement for life. This study is order to evaluate the causes and control strategies of thrombosis in mechanical valve replacement patients. Methods:1036 cases of valve replacement patients were retrospectively in the First affiliated hospital of Zhejiang University from 2008.1.1 to 2010.1.1. The statistical analysis are completed by SPSS 16.0 and Microsoft Excel XP. Results:Of all the 1036 patients,9 cases of cerebral embolism were none aortic valve replacement patients,3 cases of MVR,5 cases of DVR, and 1 cases of CABG+DVR. During the same period, there is no case of severe bleeding happened. We found that the INR was lower than the range of treatment in all of 9 cases with cerebral embolism. The average of diameter of left atrial was increased significantly and the plasma fibrinogen content was higher. Most patients of cerebral embolism with thrombosis, atrial fibrillation and other diseases. Conclusion:The start time and optimal level of anticoagulation should be individualized. High-risk patients should be monitored strictly. The larged diameter of left atrial, increasing of plasma fibrinogen content, thrombosis and atrial fibrillation are high risk of embolism after mechanical heart valve replacement.