Pharmaceutical Practice of Clinical Pharmacist in Anticoagulant Therapy for a Postoperative Bioprosthetic Valve Patient with Suspected Heparin-induced Thrombocytopenia

OBJECTIVE To explore a novel oral anticoagulation regimen for warfarin-contraindicated patients in the early postoperative period after bioprosthetic valve replacement.

METHODS Clinical pharmacists participated in the anticoagulation management of a patient with heparin-induced thrombocytopenia(HIT) post bioprosthetic valve replacement. Addressing the anticoagulation challenge in this case, pharmacist proposed an individualized regimen: anticoagulation with oral rivaroxaban following argatroban within 6 months after surgery.

RESULTS After obtaining informed consent, the treatment team adopted the pharmacists’ recommendation. Follow-up at 1, 2, 3, and 6 months postoperatively showed gradual platelet count recovery, with no thromboembolic or bleeding events.

CONCLUSION Rivaroxaban may serve as an alternative for thromboembolism prevention in the early postoperative period after bioprosthetic valve replacement. Clinical pharmacists should leverage their expertise to assist physicians in exploring innovative therapies and optimize follow-up to ensure medication efficacy and safety.