Low-dose warfarin in patients with Carbomedics heart valve prostheses

All patients who received a Carbomedics heart valve prosthesis were assessed retrospectively by interview regarding thromboembolic, hemorrhagic, or other valve-related events. In cases of such events, the patient's practitioner or cardiologist was interviewed. Hospital records were reviewed in cases of hospital admission. Included in the study were patients who had isolated replacement of the aortic or mitral valve in whom it was possible to collect all International Normalized Ratio values from discharge through follow-up. There were 148 patients with isolated aortic valve replacement and 56 with isolated mitral valve replacement. Bleeding events were 3 times more frequent than thromboembolic events. Based on our results we will apply an International Normalized Ratio between 2 and 2.5 for patients with a Carbomedics heart valve prosthesis in aortic position and ratios between 2.5 and 3 for those with a mitral valve prosthesis.