关键词: 经导管主动脉瓣置入术, 华法林, 抗菌药物, 药物相互作用

Abstract: Objective To learn the antithrombosis management strategy after transcatheter aortic valve implantation (TAVI) and the drug-drug interactions between warfarin and antimicrobial agents based on the real case, and provide a reference for optimizing therapeutic options. Methods We described and analysised a case, and reviewed the relevant literature. Results By reviewing the relevant literatures, combined with clinical experience, warfarin was chosen as the postoperative antithrombotic drug of a patient who accepted TAVI. When warfarin was used in combination with antimicrobials (moxifloxacin, levofloxacin, piperacillin tazobactam, fluconazole), the patient's international normalized ratio (INR) increased to 5.53, which was consistent with conclusions of the literatures. According to the INR values, we timely adjusted the dose of warfarin, and avoided the occurrence of bleeding events. In addition, we educated the patient, once she stopped taking the fluconazole, she needed increasing the dose of warfarin and the frequency of INR monitoring. Conclusion The antithrombosis management strategy after TAVI requires individualization. The effect of the interactions between warfarin and antibacterial agents can be very obvious. Thus, individuals receiving interacting medications are likely to require increased INR monitoring, so as to achieve the best anticoagulant effect and reduce the incidence of adverse reactions.

Key words: transcatheter aortic valve implantation(TAVI), warfarin, antibacterial agents, drug-drug interactions