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Publication Type: Safety Alert
Single or Multiple Incident: Multiple
Date: 7/14/2021 12:00:00 AM
Country: United Kingdom
Organization: NHS Commissioning Board

This alert discusses the safety incidents which can occur when patient with a mechanical heart valve is switched from a vitamin K antagonist (usually warfarin) to an alternative anticoagulant such as a low molecular weight heparin or a direct oral anticoagulant. While patients with prosthetic mechanical heart valves require life long anticoagulation to prevent emboli formation, the type of anticoagulant used is critical. During COVID-19 there was a move to transition patients treated with a vitamin K antagonist to another anticoagulant which would reduce the frequency of clinic attendance for monitoring. However, since March 2020, there have been adverse events in patients whose medication was switched. The alert provides recommendations to practitioners to ensure safe anticoagulation in patients with mechanical heart valves.

Additional Details

mechanical heart valve
anticoagulants, vitamin K antagonist, warfarin, low molecular weight heparin, direct oral anticoagulant
Medication/IV List:
antithrombotic agents (anticoagulants)

Inappropriate anticoagulation of patients with a mechanical heart valve