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Sep 23, 2014

Self-Management Improves Outcomes for Patients with Heart Valve Implants

Empowering patients with heart valve implants to manage their own health reduces risk of complications, finds study.

Empowering patients with heart valve implants to manage their own health reduces risk of complications, according to a study published in the European Heart Journal.

After being introduced in the early 1960s, valve replacements have become a very effective way to treat heart valve disease, which occurs when any of the heart’s four valves fail to work properly. Not only can valve replacement improve heart function for patients with valve disease, this procedure helps minimize symptoms like chest pain and shortness of breath. But like all procedures, valve replacements carry certain risks and require close monitoring to reduce risk of complications. The good news is that allowing patients to closely manage their own health after a valve replacement may help improve outcomes.

Through the ESCAT III (Early Self-Controlled Anticoagulation) trial, researchers tested self-management of anti-clotting medication in patients with mechanical heart valves. Patients receiving mechanical heart valves are often required to take blood thinners for the rest of their lives to prevent risk of complications, but achieving the perfect balance can be difficult. That’s why researchers trained study participants to test their blood weekly to see if it clots too slowly or quickly and make necessary changes to remedy imbalances, like by eating differently or increasing physical activity. For two years, patients received phone-support and regular check-ups to help with their self-management.

After following more than 1,300 patients for two years, researchers found that this self-management program helped reduce risk of bleeding and complications associated with blood thinners. Based on their findings, they also conclude that having patients test their blood once a week is enough to improve outcomes and testing more frequently would be unnecessary.

Results are promising for patients with mechanical valve implants, who require close monitoring to reduce risk of complications from daily blood thinners. Not only could self-management help patients better manage risk associated with treatment, this strategy is much more convenient than having frequent office visits for blood tests. And the easier it is for patients with mechanical valves to manage their medication and reduce risk of complications, the better their outcomes will be.

Questions for You to Consider

  • What is heart valve disease?
  • Heart valve disease, also referred to as valvular heart disease, occurs when any of the heart’s four valves fail to work properly. Heart valve disease happens when the heart’s valves can’t open far enough to let blood through (stenosis) or can’t close enough to prevent blood from flowing back into the heart (regurgitation).
  • What types of heart valves are used for valve replacement?
  • There are two types of heart valves used for valve replacement—mechanical and biological valves. Mechanical valves are made of man-made, durable materials that last a very long time. Biological valves are made from heart tissue and don’t last quite as long as the durable, man-made valves. However, patients receiving mechanical valves often need to take blood thinners for the rest of their lives to prevent blood clots.

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