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https://doi.org/10.15836/ccar2022.315

Patient and family education on the anticoagulant therapy after mechanical aortic valve replacement

Dragana Jurčić orcid id orcid.org/0000-0003-2926-1258
Milka Grubišić orcid id orcid.org/0000-0003-2092-5396
Katarina Karimanović orcid id orcid.org/0000-0003-0336-0960
Mia Čarapina


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Abstract

Keywords

mechanical valve; anticoagulant therapy; education

Hrčak ID:

289878

URI

https://hrcak.srce.hr/289878

Publication date:

8.12.2022.

Visits: 498 *



The choice of aortic valve depends on many factors, including the characteristics of the valve itself. A mechanical valve lasts longer than a biological one but requires lifelong anticoagulant therapy. After implantation of a mechanical aortic valve there is a high risk of clot formation, and the drug of choice is warfarin. Warfarin therapy requires strict discipline and control of therapy, which is why patients require a comprehensive approach and education. Education about the use of anticoagulant therapy should be an important part of care for the patient. The nurse plays a major role in the application of anticoagulant therapy after the implantation of a mechanical aortic valve, in terms of patient and family education. Teaching should be adapted to each patient individually, accompanied by written sources and using different teaching methods (1). Effective education about anticoagulant therapy includes understanding the very purpose and effect of the drug, dosage, international normalized ratio target range, self-monitoring strategies, the importance of regular monitoring with laboratory tests and the possibility of complications (2). Also, patients should be educated about reducing the risk of bleeding and injury, as well as procedures if bruises, nose/gum bleeding, blood in the urine and/or stool, vomiting of blood, heavy or prolonged menstruation occur. It is recommended that patients point out that they are using blood thinner therapy, furthermore, they should possess an anticoagulation card and always carry it with them. Given that patients require chronic use of anticoagulant therapy after the implantation of a mechanical valve, the approach should be systematic and coordinated not only by nurses, but by all healthcare workers. It is important that patients are educated in the hospital so they can properly carry out their therapy at home and achieve better clinical outcomes for themselves. Education should be continued on an outpatient basis and/or through day hospitals.

LITERATURE

1 

Pratt KJ, Jalilvand A, Needleman B, Urse K, Ferriby M, Noria S. Postoperative outcomes based on patient participation in a presurgery education and weight management program. Surg Obes Relat Dis. 2018 November;14(11):1714–23. https://doi.org/10.1016/j.soard.2018.08.006 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/30274740

2 

Tafur A, Douketis J. Perioperative management of anticoagulant and antiplatelet therapy. Heart. 2018 September;104(17):1461–7. https://doi.org/10.1136/heartjnl-2016-310581 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/29217632


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