Application of low-intensity anticoagulation after On-X mechanical aortic valve replacement

J Cardiothorac Surg. 2025 Jan 9;20(1):49. doi: 10.1186/s13019-024-03215-7.

Abstract

Objective: To explore the safety and efficacy of low-intensity anticoagulation in patients after On-X mechanical aortic valve replacement.

Methods: A total of 104 patients undergoing aortic valve replacement in Cardiac Surgery Department of Sichuan Provincial People's Hospital from December 2018 to December 2021 were randomly divided into low-intensity anticoagulant (INR:1.5-2.0) and high-intensity anticoagulant (INR:2.0-2.5) to compare the incidence of adverse events related to postoperative anticoagulation between the two groups.

Results: Fifty-three patients were included in the low-intensity anticoagulation group (INR 1.5-2.0), and 51 patients were included in the high-intensity group (2.0-2.5). There was no significant difference in baseline data and surgical index between the two groups (P > 0.05); there were statistically significant differences in PT, INR and bleeding events (P < 0.05), but no significant difference in embolic events (P > 0.05).

Conclusion: For patients requiring On-X mechanical aortic valve replacement who have no risk factors for thromboembolism, it is appropriate to control the INR in the target range 1.5-2.0, which can reduce the incidence of bleeding adverse events and significantly improve the quality of life, without increasing the risk of thromboembolic adverse events.

Keywords: Aortic valve replacement; Complications; Low-strength anticoagulation; On-X mechanical valve; Warfarin.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anticoagulants* / administration & dosage
  • Anticoagulants* / therapeutic use
  • Aortic Valve* / surgery
  • Female
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Heart Valve Prosthesis Implantation* / methods
  • Humans
  • International Normalized Ratio
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Thromboembolism / etiology
  • Thromboembolism / prevention & control

Substances

  • Anticoagulants