Thromboembolism is a serious complication after prosthetic heart valve replacement and requires postoperative anticoagulation therapy regardless of whether mechanical or biologic valves are used. Mechanical valves should be treated with lifelong anticoagulation, while biologic valves should generally be treated with short-term anticoagulation, and long-term low-grade anticoagulation is also advocated. The mastery of appropriate anticoagulation therapy is a guarantee of the efficacy and patient safety of valve replacement. 1, anticoagulation methods and monitoring 1, oral warfarin, simple and easy to use, for domestic and foreign use of the most options. If it cannot be taken orally or if the gastrointestinal absorption is poor in the early postoperative period, intravenous heparin sodium is used, and the effect is really reliable. 2, the postoperative effect of warfarin alone is not good, can be combined with anti-platelet drugs, such as aspirin. Aspirin is difficult to tolerate in some patients and often leads to complications such as esophagitis, ulcers and bleeding, while pansentine is easily absorbed orally, so warfarin can be used in combination with pansentine. 3.After valve replacement, regular blood tests are required. The common standard for maintaining anticoagulation strength is to maintain prothrombin time (PT) at 16-24 S and international normal ratio (INR) at 1.5-2.0. 4.The effect of early oral anticoagulants in the early postoperative period is often not easy to stabilize, as shown by the large fluctuation of test results, which may be related to the early postoperative period The reasons for this may be related to the complicated medication in the early postoperative period, poor absorption in the gastrointestinal tract and the influence of diet. Therefore, early postoperative testing should be done diligently, and the review cycle can be extended after the anticoagulation effect is stabilized. Second, the factors affecting anticoagulation therapy 1, the influence of other drugs: oral warfarin is susceptible to the influence of other drugs, some enhanced, some weakened. Now give categorization. Enhanced effect: alcohol, sulfonamide, cimetidine, steroids, anti-inflammatory pain, salicylates, etc. Decrease the effect: vitamin K, sleeping pills, estrogen, oral contraceptives, rifampin, etc. 2, the effect of diet: postoperative diet can interfere with the anticoagulant effect of warfarin, but not directly, generally very little interference. Generally do not have to change the diet, and do not have to restrict the diet. However, long-term consumption of foods rich in vitamin K, such as spinach, tomatoes, pork liver, etc., can make the prothrombin time shortened. Therefore, avoid long-term alcohol consumption or monotonous eating a kind of vitamin K-rich food. 3, other factors influence: such as age, older people are more sensitive to this type of drugs. Such as disease, for those with liver disease, the function of the clotting factors on which the liver makes vitamin K is impaired, and the sensitivity to oral anticoagulants is increased. Third, the need for surgical anticoagulation 1, non-stop anticoagulation: body surface minor surgery, such as clean sutures, thoracic puncture, etc. 2, postpone anticoagulation: valve replacement has not yet started anticoagulation therapy, but also need emergency surgery, such as tracheotomy, acute renal failure dialysis, etc., should postpone the start of anticoagulation. 3, discontinue anticoagulation: valve replacement after emergency surgery, can be intravenous vitamin K1 20mg after surgery, intraoperative should be carefully hemostasis, review PT. 48 hours after surgery to restart anticoagulation. 4.Suspension of anticoagulation: If elective surgery is required after valve replacement, anticoagulants can be discontinued 2 days before surgery and replaced by intravenous heparin, and discontinued the night before surgery, and surgery after checking PT close to normal. Restart anticoagulation 48h postoperatively. Note that the resumption of anticoagulation therapy after cranial surgery should be late, usually 5-6 weeks after surgery. IV. Special problems and treatment of anticoagulation therapy for women of childbearing age 1. Menstruation: Women with normal menstruation before surgery have some changes in their menstrual period and volume after surgery due to anticoagulant administration. In order to reduce bleeding, generally stop using warfarin on the day of the onset of menstruation and the day before basic cleanliness, and continue to take it at other times. 2, oral contraceptives: estrogen and oral contraceptives can reduce the anticoagulant effect, so pay attention to blood tests to check PT, timely adjustment of the dose of medication. 3, pregnancy: women with significant improvement in hemodynamics and cardiac function after valve replacement may be allowed to become pregnant after 2 years postoperatively. However, it should be clearly pointed out that: firstly, due to the high cardiac load after pregnancy, the blood pressure is in a hypercoagulable state, which can endanger the safety of mother and child. Secondly, long-term use of anticoagulants carries the risk of causing malformations, especially in the first trimester. In addition, close contact should be maintained with medical personnel during pregnancy to receive treatment and life guidance. 4. Perinatal management: admit to hospital 1-2 weeks before the expected date of delivery, discontinue anticoagulants during hospitalization, switch to heparin anticoagulation, and treat as elective surgical anticoagulation. Restart anticoagulation 48h after surgery. Cesarean section is usually used, and for natural delivery, great caution should be exercised.