INR goal

[Herb M]

I am getting different recommendations from my Internist/ cardiologist and my invasive cardiologist. The Internist/cardiologist says the goal should be 2.5 and the invasive cardiologist says 3.0.

I have a St. Jude aortic valve. The rcommendations that appear in my INR printouts from my blood test state:

Bi-leaflet mechanical valve in the aortic position : Goal 2.5
Mechanical prosthetic valve (high risk): Goal 3.0

The St. Jude is a bi-leaflet valve, so I am a bit confused about which is the proper goal. Anyone have an opinion on this?

 

[fyrfytr]

Hi Herb
I had a St. Jude mechanical aortic valve in April of this year and both my Cardiologist and my surgeon said I should be between 2.5 and 3.5. I have been pretty steady around 2.9 so far. I hope this helps you out alittle.

Dave
_________________________________
Surgery: 4/21/03
Aortic Aneurysm Repair
AVR, with a St. Jude Mechanical
Heart Center of the Rockies

 

[Ross]

Recommended is 2.5 to 3.5. As long as your in this area, you are fine. Some people have bleeding problems and are sometimes told to keep it at the lower end of the range, but most all of us like to keep it at the higher end. It's easy and dangerous to go too low. If it's high, at least we have some room to work with it.

None of this is set in stone, but have a look see below:

http://www.sjm.com/procedures/procedure.aspx?name=Heart+Valve+Replacement&section=FAQ#90

 

[EVELYN]

Hi Herb

Ditto what Fyrfytr said. Tyce had an aortic valve replaced about a year and a bit ago and both our cardio and his surgeon said to keep the INR between 2.5 and 3.5.........EASIER SAID THAN DONE, ESPECIALLY IN THE SUMMER.
Good luck.

Evelyn

 

[JimL]

My opinion is based on nearly two years of experience with my St. Jude's -- but you have fifteen years!

During the first weeks and months, I wanted to keep my INR as low as possible to avoid the bleeding possibilities. Then it sunk in that the bleeding what a minor problem that probably wouldn't happen (it hasn't), but the stroke possibility was very real; I don't think that has happened either.

I was recommended to keep the INR at 2.5, but I feel much more comfortable mentally having it at 3.0 or a little more.

Of course, the INR is not the firmest thing there is. Practically, there is little difference at all between an INR of 2.5 and and INR of 3.0.

 

[Sunshine susan]

My AVR surgery ws 4-1/2 years ago, and I am supposed to keep my INR between 2.5 and 3.5. I personally like it on the higher side, however, my cardio said that with an aortic valve it wasn't that big a deal because the blood flows over the valve so fast that clots are generally rare in people with no other contra indications. It is different for mitrial valve replacements where the blood flow is much slower, thus the anticoagulation a much more important factor. Just for the "whatever it is worth" department.....Susan

 

[Herb M]

Thanks for all the responses. It seems that it is unanimous that 3.0 should be the goal. I will have to confront my Internist.

 

[Ross]

Herb as long as your anywhere from 2.5 to 3.5 don't worry about it. You'll drive yourself absolutely insane trying to maintain one number. In fact, it's downright impossible anyway. We just like to have ours in the higher end of the scale for wiggle room in our diets. If your one that eats alot of things with Vit K, be sure you stay consistent and allow a doseage change to accommodate that diet.