Blood Thinners (Coumadin Therapy And Monitoring) Required For Patients Receiving Mechanical Valve Replacements
The Achilles Heel of selecting a mechanical valve replacement are blood clots and the side effects of blood thinners like warfarin (aka Coumadin therapy).
Blood clots on mechanical valves can cause the valve to "stick" after mitral, pulmonary, tricuspid or aortic valve replacement sugeries.
More commonly, however, blood clots on the replacement valve can "flick off" the valve and enter the bloodstream. Unfortunately, this can cause blockage of arterial branches anywhere in the body, such as in the eyes, fingers, kidneys, intestine, spleen, legs, or the brain where it can cause a stroke.
Warfarin (the generic name for Coumadin Therapy) is administered to prevent clots from forming on the mechanical valves. Coumadin acts as an anticoagulant. That said, coumadin therapy is the primary medication used to slow down the body's clotting system.
However, too much use of this medicine can lead to serious bleeding complications from ulcers, injuries, or even spontaneous bleeding in the brain, kidneys or other internal structures.
Coumadin Blood Tests And Coumadin Therapy Monitoring
Patients taking Coumadin treatment must be monitored periodically with blood tests to assure the Coumadin dosage and Coumadin level is right.
This blood test is called a PT (also called protime or prothrombin time). The PT predicts how long it takes your blood to clot. Your doctor uses the PT to determine your Coumadin dose.
The normal PT range is 11-13 seconds. This is frequently called the control. When you are taking Coumadin, your PT will be greater than the control. This is called the therapeutic range. Before you leave the hospital, your doctor or nurse will tell you what your therapeutic range should be.
If the PT level is less than the therapeutic range, the blood may clot too quickly. This would increase the chance of blood clots forming on your mechanical valve. If this happens, there is a risk that your valve will not work correctly. There is also a possibility that small clots will break off and cause a stroke.
If the PT level is greater than the therapeutic range, the blood will take too long to clot. This will increase the chance of unusual bleeding. Contact sports or activities, such as skiing, that risk blunt trauma, can be dangerous.
It is very important to keep a record of your daily Coumadin dose and your Coumadin blood tests. You will probably be given a Coumadin Therapy worksheet. On this worksheet, you should write down the time and amount of each Coumadin dose and you should also write down the result of each PT test.
>> NEXT: To learn more about coumadin side effects, pregnancy issues, dietary restrictions and coumadin bracelets, please click here.
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