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Notes:
conferenceseries
.com
Volume 8, Issue 9 (Suppl)
J Clin Exp Cardiolog, an open access journal
ISSN: 2155-9880
Euro Cardiology 2017
October 16-18, 2017
October 16-18, 2017 | Budapest, Hungary
20
th
European
Cardiology
Conference
J Clin Exp Cardiolog 2017, 8:9(Suppl)
DOI: 10.4172/2155-9880-C1-078
35 years of warfarin, standing the test or challenge of time?
Yanal F Al-Naser
Queen Alia Heart Institute, Jordan
A
46 year old female patient, with no medical illnesses was referred to my clinic with effort intolerance , and palpitations
of four years duration. Her history dates back to when she was 11 when she had an Aortic and Mitral valve replacement
due to rheumatic causes, she had a size 19mm bileaflet mechanical aortic valve and a size 27mm bileaflet mechanical mitral
valve. She was started on warfarin and took it for three months of her life as documented by her family members and follow
up notes till she decided to stop it. She stated that she took no medications at all and was completely asymptomatic , she got
married and had three children, all a normal vaginal delivery aided by a mid-wife at home! Her 2DECHO showed a grade three
paraleaking aortic and mitral valves, and was referred to me for a redo AVR and MVR 35 years later, being off warfarin for all
that period and was asymptomatic for 30 years and never had a stuck valve! Her coagulation profile was normal, with an INR
of 1,I operated on her and found a rim of pannus surrounding the valves, but the leaflets were mobile. I replaced both valves
using St Jude size 21 Aortic Valve and size 29 Mitral valves, both mechanical. There are a few cases described in literature about
mechanical valves with no warfarin, but I believe this is one of those with the longest –off warfarin- history.
Yanalfn1@yahoo.com