A patient with a prosthetic heart valve needs to receive antithrombotic therapy. The primary risk for thromboemboli is during the first 3 months after surgery, but some patients benefit from prolonged therapy.
Antithrombotic regimens:
(1) aspirin 75 to 100 mg per day (an alternative agent is needed if there is aspirin intolerance)
(2) warfarin therapy
Therapy for First 3 Months After Valve Replacement Surgery
Prosthetic Valve
Preferred
Alternative
mitral valve
warfarin with INR 2.5 to 3.5
aspirin
aortic valve
aspirin
warfarin with INR 2.0 to 3.0
After the first 3 months many patients are kept on aspirin for the rest of their lives.
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