D. 2.5-3.5 – Explanation
Mechanical valves – target INR:
- aortic: 2.0-3.0
- mitral: 2.5-3.5
Prosthetic heart valves
The most common valves which need replacing are the aortic and mitral valve. There are two main
options for replacement: biological (bioprosthetic) or mechanical.
| Biological (bioprosthetic) valves | Mechanical valves |
| Usually bovine or porcine in origin Major disadvantage is structural deterioration and calcification over time. Most older patients ( > 65 years for aortic valves and > 70 years for mitral valves) receive a bioprosthetic valveLong-term anticoagulation not usually needed. Warfarin may be given for the first 3 months depending on patient factors.Low-dose aspirin is given long-term |
.The most common type now implanted is the bileaflet valve. Ball-andcagevalves are rarely used nowadaysMechanical valves have a low failure rateMajor disadvantage is the increased risk of thrombosis meaning longtermanticoagulation is needed. Aspirin is normally given in additionunless there is a contraindication. Target INR
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Following the 2008 NICE guidelines for prophylaxis of endocarditis antibiotics are no longer
recommended for common procedures such as dental work.
