Early Postoperative Anticoagulation After Mechanical Valve Replacement

[Dustin]

Dear Mechanicals,

When did you start your anti-coagulation therapy after the insertion of your mechanical heart valve? Your input is greatly appreciated. :)

[baradonai]

If fuzzy memory serves, it was while I was still in the hospital. I had to return to the coumadin clinic within a week of release.

[Birky]

They started when I was in the hospital and then had to go the nex week to get tested. In fact, it was twice that week.

[geebee]

I am pretty sure they started the day after each of my surgeries.

[Cooker]

I started in the hospital and tested once a week for five weeks. As soon as I was at 2.5 for two test in a row I went to monthly testing.

[bvdr]

I came out of surgery with a heparin drip infusing and coumadin was started right away and was up to 2.0 before they discontinued the heparin drip. i was still at 2.0 when I was discharged although my range was 2.5-3.5. I was tested after I was home 3 days and then again at a week.

[Blanche]

It was exactly as Betty stated for my husband.
Blanche

P.S. Betty it is so good to see you!

[Rivet]

I started a couple days after surgery. On the day I was released, my INR was too low so I had to give myself Lovenox injections twice a day at home for the first week until the INR was above 2.0

[Ross]

Immediately after surgery.

[allodwick]

You should be on something as soon as your wound stops bleeding.

[Dustin]

OK, so starting ACT in the hospital appears to be the norm with a possible drip of heparin when you leave the operating theatre. I'll keep this in mind, you never know how protocols vary from hospital to hospital.

[RandyL]

I came out of surgery with a heparin drip infusing and coumadin was started right away and was up to 2.0 before they discontinued the heparin drip. i was still at 2.0 when I was discharged although my range was 2.5-3.5. I was tested after I was home 3 days and then again at a week.

Same here!

[Marty]

You should be on something as soon as your wound stops bleeding.

I was on something, all right. I went home day 4 on 5mgm/day. My INR was 5.6 taken at home by visiting nurse at one week.I don't know if any doctor was notified but no dose change. My first post op chest Xray at two weeks showed blood up to my collar bone left chest cavity. The PA ( my surgeon said he was no good at it!) skillfully drained four pints of blood. It did not reaccumulate and I eventually found my correct dose at about 3mgm/day. I asked my cardiologist about all this and he said it happens all the time! A review of the literature and consultation with a family friend nursing at Hopkins heart surgery recommends that old people, (I was 72 at the time )should get no more than 2.5mgm/day post op and find their individual dose in due time.

[afraidofsurgery]

I came out of surgery with a heparin drip infusing and coumadin was started right away and was up to 2.0 before they discontinued the heparin drip. i was still at 2.0 when I was discharged although my range was 2.5-3.5. I was tested after I was home 3 days and then again at a week.

Pretty much same for me, although I was at 1.7 and went home on Lovenox. I had to get to 2.0 at home before I could stop the Lovenox (home nurse stopped by to take blood for this). After I could drive I went in to the local urgent care center for blood draws to send to the hospital lab, and my INR and coumadin has been coordinated with my cardiologist since.

Patty