Warfarin is an anticoagulant commonly used after heart valve replacement, and the proper use of this drug will directly affect the quality of life after valve replacement. Overdose may lead to bleeding, which can be life-threatening, while underdose may lead to thrombosis, resulting in valve dysfunction or circulatory embolism, which can also be life-threatening. The following is a brief description of the use of warfarin after heart valve replacement. Heart valves: There are four groups of valves in the heart, namely mitral valve, aortic valve, tricuspid valve and pulmonary valve, which are one-way valves that open and close alternately with the heart’s systolic and diastolic cycles to ensure that the heart’s blood is delivered in the normal direction and to maintain the body’s blood circulation. When the heart valve suffers from rheumatic activity, bacterial infection, degeneration and trauma, congenital malformation and other pathologies and damage occurs, the valve loses its one-way valve function, which affects the normal blood discharge of the heart, and then affects the function of the heart, resulting in cardiac insufficiency, so the valve needs to be repaired or replaced. Disadvantages: anticoagulants should be taken for life to ensure that the anticoagulation index is within a suitable range; otherwise, thrombus may lead to “stuck valve” and cardiac arrest. 2, biological valves: advantages: low thromboembolic rate, no lifelong need for anticoagulants; disadvantages: poor valve durability, working life is generally about 15 years, depending on the patient’s metabolic status, age and other factors, generally for older people over 60 years of age or patients with contraindications to anticoagulation. 3, anticoagulation therapy: commonly used anticoagulant is warfarin, domestic preparation is 2.5mg/tablet, imported preparation is 3mg/tablet; after discharge, you can perform coagulation check once or twice a week (mainly monitor INR value, i.e. International Normalized Ratio) and adjust the dosage of warfarin, when your dosage of warfarin is stable, the frequency of coagulation check can be gradually reduced, but it is recommended that every 4-6 weeks still perform Once the dose of warfarin has stabilized, the frequency of coagulation tests can be gradually reduced, but it is recommended to still perform a test every 4-6 weeks. 4. How much anticoagulation is appropriate: for patients with prosthetic mechanical valves, the INR (International Normalized Ratio) should be kept between 1.8-2.3 for simple aortic valve replacement; for simple mitral valve replacement or mitral + aortic valve replacement, the INR should be kept between 1.8-2.5, and if there is a tricuspid prosthetic mechanical valve, the INR should be kept between 2.0-2.5; for patients with biologic valves, the anticoagulation should be kept within six months after surgery. If the patient is combined with atrial fibrillation, lifelong anticoagulation is recommended regardless of whether a mechanical valve or a biologic valve is used; 5. Food: Grapefruit, mango, fish oil, garlic, etc.; 2. If you need to add or stop a drug or change your diet, you should increase the number of times you monitor INR and PT, and adjust the dose of warfarin or adjust your habits in time to avoid unnecessary bleeding or thrombosis and achieve a satisfactory anticoagulation effect. 6, warfarin adjustment method: INR value less than 1.5 indicates insufficient anticoagulation, need to increase the amount of medication; greater than 2.5 indicates anticoagulation overdose, need to reduce the dosage, each time you can increase or decrease the amount of 1/4 tablets. For patients who are particularly sensitive to warfarin, each adjustment can be increased or decreased by l/6 to 1/8 of the tablet amount, and the drug should be stopped for a day if it exceeds 3.0. If the INR value is unstable, the number of blood tests should be increased as appropriate, and the number of stable patients can be decreased as appropriate. Remember to take it at the same time every day, preferably after dinner every day, and remember not to forget to take it! 7, other drug therapy: cardiac diuretics need to take 6-12 months, or even longer, pay attention to the reaction to medication. 8.Female fertility guidance: Although there is information showing that low-intensity warfarin anticoagulation does not lead to the occurrence of fetal malformations, it is still recommended that those who intend to become pregnant consult with their doctors and use appropriate anticoagulation strategies to ensure the birth of a healthy child. 9.Prevention of infection: In case of pharyngitis, tonsillitis, skin boils, or oral infections, antibacterial drugs should be applied promptly to prevent systemic infection and sepsis, which can then form plaque around the valve and affect the normal work of the prosthetic valve. 10.Activities and resumption of work: activities should be carried out gradually, and it is appropriate to increase the heart rate not higher than 20% of the original heart rate; one month after the operation can be engaged in housework and light physical labor, and six months later can gradually participate in normal work. 11, review: six months to a year is recommended to return to the hospital for a comprehensive review, including routine blood, coagulation function, blood biochemistry, electrocardiogram, chest X-ray, echocardiography, etc. 12. Complications and treatment of anticoagulation: 1. Thrombosis and embolism: sudden appearance of black eyes, fainting, vision change and hemiparesis, etc., or sudden appearance of pain, coldness, pallor, limitation of activity and loss of pulse in one limb without trauma, may be thrombosis or embolism, and should be immediately referred to the hospital. 2. Bleeding: ① Light bleeding: such as gum bleeding, skin petechiae, the dosage of Warfarin can be reduced according to the laboratory results: ② Obvious bleeding: such as nosebleed, hematuria, stop taking Warfarin tablets for 1 to 2 days; ③ Severe bleeding: such as hemoptysis, vomiting blood, intracranial bleeding, stop anticoagulant immediately and go to the hospital for examination and treatment; ④ For female patients, during menstruation, most of them do not have much menstrual flow and the dosage of anticoagulant remains the same; If the amount of menstruation becomes more, or the time is prolonged, the dosage of anticoagulant should be adjusted at the hospital under the guidance of the doctor. If you have the following conditions, please go to the hospital or consult your doctor: 1. Infection in any part of the body; 2. Unexplained fever; 3. Coughing up foamy or bloody sputum; 4. Obvious shortness of breath and/or swelling of the lower limbs and eyelids; 5. New arrhythmia; 6. Bleeding tendency such as subcutaneous bleeding and hematuria; 7. Unexplained nausea and vomiting, sclera and skin jaundice; 8. Sudden black eye, syncope, hemiplegia or pain, chill and pallor in lower limbs.