Date
August 2009	Aortic and mitral valvuloplasty due to severe rheumatic stenosis of the aortic and mitral valves.
February 2017	Mechanical valve replacement of aortic and mitral valves.
March 2017	Stop visiting the clinic of patient's own volition due to side effects of warfarin including tingling sensation and numbness of legs, urticaria, skin rash, and nausea.
December 2018	Non-ST-elevation myocardial infarction due to coronary artery embolism. Restart warfarin.
February 2019	Patient complaint of side effects of warfarin such as tingling sensation and numbness of legs, urticaria, and skin rash. Refusal to taking warfarin. Start apixaban 5 mg b.i.d. PO
April 2020	Atrial fibrillation was developed. No prosthetic valve thrombosis or intracardiac thrombi on computed tomography. Successful electrical cardioversion was performed without any thrombo-embolic event.
Until February 2021	No development of major bleeding, stroke, or systemic embolism with apixaban