If you have just had heart valve surgery (valve replacement or valvuloplasty), you will need to take anticoagulants and have your blood drawn frequently for anticoagulation indicators. Regarding some common questions, I think the following knowledge should be useful for you: 1. What anticoagulant do I need to take for anticoagulation? Take warfarin or a drug called warfarin. 2.What is the dose of warfarin? At present, there are two doses of warfarin in China, the imported warfarin is 3mg a piece; the domestic warfarin is 2.5mg a piece. Therefore, the doctor told you to take a piece or a piece and a half, must know in advance to take the specifications of warfarin is how much, otherwise there is a great risk of bleeding or thrombosis risk. 3.How long do I have to take warfarin? If you are replacing a mechanical flap, you have to take it for the rest of your life; if you are replacing a biological flap or doing valvuloplasty surgery, you can take it for 4-6 months after the surgery. 4.What are the side effects of warfarin? Not eaten well side effects are great, eaten well there are no side effects. If you take too much, you will bleed (such as brain bleeding, stomach bleeding, nose bleeding, etc.), and if you take less, it will not work as an anticoagulant (forming thrombosis, requiring surgery again). Therefore, we must often take blood tests for anticoagulation, and adjust the amount of food each day according to the test results. 5.What is the so-called “blood test and anticoagulation check”? You don’t need to know what it means in Chinese, just remember what it’s called. 6.How much is the “INR” appropriate? The standard in China is 1.8-2.5, usually 2.5-3.0 for tricuspid valve, 2.0-2.5 for mitral valve, 1.8-2.0 for aortic valve. if you are replacing the mitral and aortic valves, remember 1.8-2.5 is fine. Never look at the reference value above the lab sheet, that is relative to a normal person without valve replacement. 7, such as can look at the results of the laboratory test and according to the results of the drug adjustment? It is recommended to only look at the third INR of the lab sheet. Generally speaking, the INR is high if you eat more and low if you eat less. If the INR is lower than 1.8, it means that you are not taking enough warfarin, if it is greater than 2.5, it means that you are taking too much warfarin. For example: you currently take 3mg daily, today’s INR is 2.8, then it proves that you eat more warfarin, you can reduce 0.75mg (1/4 tablet); if today’s INR is 3.5, it means that you eat too much, usually require 1-2 days after stopping the drug, and then take the drug according to the test results; on the contrary, if today’s INR is 1.25, it proves that you eat less warfarin. On the contrary, if your INR is 1.25 today, it proves that you are taking less warfarin, add 1.5mg-3mg on top of 3mg for 1-2 days and then take the drug according to the test results. 8.How often do I need to take blood tests? Generally, the doctor will check the blood every day during hospitalization, and after discharge, it is usually required once every 2-3 days, and slowly once every 1 week or 2 weeks according to the stability of INR, and generally it is better not to exceed once a month. Generally speaking, most patients’ INR is basically stable after half a month of medication. 9.Where can we check the INR? Is it accurate in general hospitals? As long as the hospital can carry out surgical procedures can check INR, generally are accurate. Of course, if you have the conditions, it is best to go to a hospital that can carry out heart surgery. 10.Do I need to take warfarin every day? Every strip needs to be taken, and it is better to fix a certain time, for example, at 5 pm daily, or 8 pm daily. 11.What if I forget to take warfarin for a few days? In this case, it is recommended to take warfarin orally immediately (no matter what time), and the dose should be slightly increased on top of the original one, such as half a tablet or 1/4 tablet, which usually will not cause any problem, never take all the amount at once, otherwise it will bleed. It is best to go to the hospital to check the INR and decide how to use the medication later. 12.Does diet and other medications have an effect on INR? Yes. Generally, as long as you eat a normal diet (no picky or partial eating), there is no effect on INR. Many drugs have an effect on INR, such as many anti-inflammatory drugs (antibiotics), cold medicines, amiodarone, etc. will increase the INR value, so you need to reduce the dose of warfarin appropriately; some drugs such as hormones will reduce the INR value, so you need to increase the dose of warfarin appropriately. 13.How to take warfarin after valve replacement surgery? This problem is relatively complicated, you need to stop warfarin and switch to heparin. It is recommended that the surgeon ask a cardiothoracic specialist to consult and give specific advice. Let’s say you need a tooth extraction, make sure to tell your medical history or you will bleed profusely. Please remember! Some non-cardiothoracic surgery specialists do not know about anticoagulation. 14.I am taking imported warfarin, can I change it to domestic? Yes, but it is very troublesome and requires constant blood checks until the INR is stable. Be sure not to take for granted that imported drugs take one piece, domestic drugs also take only one piece; moreover, even if you eat the same dose, often check the blood results vary greatly. 15.Is warfarin expensive? Where can I buy it when I run out? Warfarin is very cheap, about$20 per month. It is best to buy warfarin from a hospital that can perform heart surgery, so there are no fake drugs. 16.I still don’t understand after reading the above instructions, what should I do? It is recommended to look up the knowledge on the Internet, and it is better to consult the doctor who performed your heart surgery, there must be a way.