INR target for mitral on- x valve and low dose aspirin

[Shiv]

I have a question.
Does anybody take low dose aspirin say 75mg for mitral On-X valve along with INR target of 2.5?

 

[brijeshb]

Yes , many of the valvers here take both low dose aspirin and an anti coagulant. My case I have On-X Aortic. I take 75 mg aspiring and keep my INR between 2 and 3

 

[pellicle]

Yes , many of the valvers here take both low dose aspirin and an anti coagulant.

which would include me ... ATS and Aortic. INR Target = 2.5

I understood that the target for Mitral was slightly higher of INR=3, however this study:

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/415179
does not differentiate between Aortic and Mitral and further the GELIA study made this finding:

we conclude that low-intensity anticoagulation with a target INR of 2.0 to 3.5 is safe for patients with SJM prostheses in the aortic position as well as the mitral position​

 

[Sheenas7]

I take a baby aspirin every night. I have mechanical mitral valve.

 

[Thomas]

St. Jude Mitral valve
INR target 3.0
81mg aspirin/day
10mg warfarin/day

 

[Shiv]

I take a baby aspirin every night. I have mechanical mitral valve.

What else along with baby aspirin? And dose? And target INR?

 

[Shiv]

which would include me ... ATS and Aortic. INR Target = 2.5

I understood that the target for Mitral was slightly higher of INR=3, however this study:

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/415179
does not differentiate between Aortic and Mitral and further the GELIA study made this finding:

we conclude that low-intensity anticoagulation with a target INR of 2.0 to 3.5 is safe for patients with SJM prostheses in the aortic position as well as the mitral position​

During the pregnancy and c section? I went to another hospital. Cardiologist said I was misguided. And he was astonished that why I took a mechanical valve. He said tissue was better that tissue will stay 15 years and after 15 yrs, TMVR can be done..

My surgeon although in 2019 said for you age 29 years, tissue is useless and it may only stay 5 years as its mitral which degrade early and you are only 29..he suggested me for mechanical valve.. he did a minimally invasive surgery without cutting the sternum which was very good. I wanted a baby
I told him about wish of child..he said who say we can't have baby on mechanical.. he told about low molecular weight heparin.

As you see medical fraternity is divided in their opinions.

Thank you all.

 

[pellicle]

He said tissue was better that tissue will stay 15 years and after 15 yrs, TMVR can be done..

this is a common formula that is regurgitated by the medical practitioners who can only think formulas

Problem is this, let say you are 29:

1. tissue valve gives you 15 years (more probable in mitral than aortic)
2. at about 44 you need to have a trans artery replacement, which will make the valve hold smaller and last for less time (say 10
3. you are now 54 ... what to do there? You have your second (Open Heart Surgery) OHS and get a new valve. Do you pick tissue probably taking you to 69 or go mechanical at that point?

either way, you are currently in the situation and from what I see there are possibilities for a successful delivery in that situation with proper management.

I'm still looking for those other posts.

Best Wishes

 

[Shiv]

I have a question.
Does anybody take low dose aspirin say 75mg for mitral On-X valve along with INR target of 2.5?

Just an update to all.

As per the latest ACC/AHA guideline 2021, which replaced the 2014 guideline, they have given class 1 recommendation for mitral valve target as 3.0. (Same as before)

For aspirin, they give downgraded the recommendation to (2B) recommendation ( weak evidence) to take aspirin along with warfarin


So I am stopping aspirin and targeting 3.0 INR with my VKAs

 

[ATHENS1964]

I quote a general link. A question for the administrators, should there be a category that has some basic links in order to find them easily?
https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000923