Publication: Complications of warfarin in post operative heart valve surgery
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Date
2013
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Institute of Medicine
Abstract
Abstract
Introduction: Thromboembolic complications and bleeding are the major complications of warfarin. The aim of the study was to focus on the complication of warfarin and monitoring post-valve surgery.
Methods: A combined retrospective and prospective study was done in post mechanical heart valve surgery patients at Manmohan Cardiothoracic Vascular and Transplant Center. The study was carried out for 4 months by interviewing patients with self-administered structured questionnaire about any complications during their follow up in OPD and monitoring for their INR values.
Results: The majority of patients studied wer male 42 and 56 were female. 55 patients underwent mitral valve replacement, 22 underwent double valve replacement and 46 underwent aortic valve replacement. There were a total of 59 cases of bleeding complications. Hemoptysis was the most common bleeding event .Pericardial bleeding was the most common major bleeding complication with 3.1%. In patients taking warfarin major bleeding complication was 10.2% and minor bleeding was 50%. Out of total INR reading 47% were out of the target INR range, with 19.5% above range and 27.5% below range.
Conclusion: Minor bleeding was the most common type of bleeding. A system for proper monitoring of warfarin can bring improvement in better dose adjustment to achieve more appropriate INR values and eventually minimizing warfarin related complications. Introducing pharmacist monitored anticoagulant clinic can reduce the work load of physicians and overcome the time barrier.
Keywords: Minor bleeding, Major bleeding, INR, Thromboembolism
Description
N Pradhan
Department of Pharmacy, Maharajgunj Medical Campus, IOM
NR Bhandari
Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic and Vascular Transplant Centre, IOM
L Bharati
Department of Pharmacy, Maharajgujng Medical Campus, IOM
Keywords
Minor bleeding, Major bleeding, INR, Thromboembolism