Anticoagulation self-testing after heart valve replacement.

The recent introduction of home testing of coagulation status offers a new opportunity for improved follow up of patients undergoing chronic anticoagulant therapy secondary to valve replacement or other conditions. A growing body of data suggests that the ability to monitor the International Normalized Ratio (INR) at home results in a greater maintenance of 'in-range' values compared to a laboratory-based testing regimen. Additional evidence suggests that this greater prevalence of 'in-range' values will translate into a lower frequency of bleeding and thrombotic complications. Thus, home INR testing appears to be developing as an important diagnostic adjunct for improving the postoperative care of patients with prosthetic heart valves, or who are receiving chronic anticoagulation therapy for other reasons.