Huang Yu, Huang Lei, Han Zhen
Department of Cardiovascular Surgery, Peking University Shenzhen Hospital, Shenzhen, China.
Front Surg. 2022 Oct 12;9:1016278. doi: 10.3389/fsurg.2022.1016278. eCollection 2022.
Heart valve replacement, as a safe and effective treatment for severe valvular heart disease, can significantly improve hemodynamics in patients. However, such patients then require lifelong anticoagulant therapy. Warfarin, a cheap and highly effective vitamin K antagonist, remains the major anticoagulant recommended for lifelong use following mechanical heart valve replacement. However, the effect of warfarin anticoagulant therapy is complicated by physiological differences among patients and non-compliance with treatment at different degrees. Effective management of warfarin therapy after heart valve replacement is currently an important issue. Portable coagulometers and the emergence of the Internet have provided new opportunities for long-term management of anticoagulation therapy, but the safety and affordability of this approach remain to be fully evaluated. This paper reviews recent progress on the use of portable coagulometers and the Internet in the management of warfarin anticoagulation therapy following mechanical heart valve replacement, which offers opportunities for reducing complications during postoperative anticoagulation and for facilitating patient compliance during follow-up.
心脏瓣膜置换术作为治疗严重瓣膜性心脏病的一种安全有效的方法,能够显著改善患者的血流动力学。然而,此类患者随后需要终身抗凝治疗。华法林作为一种廉价且高效的维生素K拮抗剂,仍然是机械心脏瓣膜置换术后推荐终身使用的主要抗凝剂。然而,华法林抗凝治疗的效果因患者之间的生理差异以及不同程度的治疗依从性而变得复杂。心脏瓣膜置换术后华法林治疗的有效管理是当前的一个重要问题。便携式凝血仪和互联网的出现为抗凝治疗的长期管理提供了新的机会,但这种方法的安全性和可负担性仍有待充分评估。本文综述了便携式凝血仪和互联网在机械心脏瓣膜置换术后华法林抗凝治疗管理中的应用进展,这为减少术后抗凝并发症以及促进随访期间患者的依从性提供了机会。