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I think I would, as the risk of thromboembolism with a prosthetic aortic valve is around 1 in 100 treated patient years. Reverse, wait ?who knows 2 weeks. Of course you need to provide informed consent to patient....weigh up risk/benefit ratio. Andy Webster -----Original Message----- From: Accident and Emergency Academic List [mailto:[log in to unmask]] On Behalf Of John Ryan Sent: 12 October 2002 12:16 To: [log in to unmask] Subject: Anticagulation and Head injuries I am aware the list has discussed this topic recently but I would like to add a new slant. Views on how to manage a young man with a head injury and headache following a fall from his bicycle.... CT shows temporal contusion. This chap is on warfairn follwing his aortic valve replacement on a background of Marfan's Syndrome. The question is to reverse anticoagulation (INR 3.5) or not ? Dr John Ryan