Application of low-intensity anticoagulation after On-X mechanical aortic valve replacement

Abstract Objective To explore the safety and efficacy of low-intensity anticoagulation in patients after On-X mechanical aortic valve replacement. Methods This study retrospectively collected data from patients diagnosed with aortic valve disease (stenosis or closed insufficiency) who underwent surgical On-X mechanical aortic valve replacement in the Cardiac Surgery Department of Sichuan Provincial People's Hospital from December 2018 to December 2021; the patients were divided into low intensity anticoagulation group (INR:1.5-2.0) and higher intensity anticoagulation group (INR:2.0-2.5) based on postoperative stable INR value (relatively stable INR for 3 months) to compare the incidence of postoperative anticoagulant-related adverse events in the two groups. Results Fifty-three patients were included in the low-intensity anticoagulation group (INR 1.5-2.0), and 51 patients were included in the higher-intensity group (2.0-2.5) in the baseline data and surgery (P > 0.05); the two groups were statistically significant in PT, INR and bleeding events (P < 0.05), but no significant difference in embolic adverse events (P > 0.05). Conclusion For patients requiring On-X mechanical aortic valve replacement who have no risk factors for thromboembolism, it is appropriate to control the INR in the target range 1.5-2.0, which can reduce the incidence of bleeding adverse events and significantly improve the quality of life, without increasing the risk of thromboembolic adverse events.