الفهرس 
Antithrombotic agentOnly 14 pages are availabe for public view
Abstract
Artificial heart valves have been in use for over five decades to replace diseased heart valves. Since the first heart valve replacement performed with a caged-ball valve, more than 50 valve designs have been developed, differing principally in valve geometry, number of leaflets and material.
Lifelong oral anticoagulation is recommended for all patients with mechanical heart valves irrespective of valve type or date of introduction and is essential for the prevention of thromboembolic events.
However, oral anticoagulation bears the problem of bleeding disorders and its diminished effect in the given clinical situation could lead to a thromboembolic episode.
Our study was prospective descriptive observational study on 159 patients after mitral valve replacement on warfarin as anticoagulation. Follow up of INR and dose and complications during admission and after one month from discharge was done 77% of patients reached target by the third day, 83% by the 4th day and increasing up to 92.5% by the 8th day.
The initial dose has a statistically significant relation with the subsequent doses. So starting dose of warfarin must be highly interpreted to decrease unnecessary doses and alterations of dose that may leads to a longer unnecessary hospital stay.
All patients who had inpatient complications also had complications after 1 month discharge. that mean need of the high attention needed to any complications occurring in hospital due to warfarin usage. the relation between doses and in hospital complications is negative but between INR and the complications from day 2 to day 7 was positive.
Major bleeding incidence was 3 patients (1.9%) in the one month post discharge follow up
The Body mass index was lower in patients who reached the target INR. They also required smaller warfarin dose. No statistically significant relation was found between age or sex with complications.