Abstract
Patients with chronic atrial fibrillation, giant left atrium, left atrial thrombi, and previous embolic accidents are usually treated with life-long anticoagulation after bioprosthetic mitral valve replacement for fear of increased thromboembolic accidents. However, we studied 306 patients in whom we implanted 381 bioprostheses between January 1976 and May 1984, with variations of anticoagulation therapy. The patients' ages ranged between 19 and 68 years, with a mean of 46.2 years. Eighty-six patients were in the New York Heart Association Functional Class II (28.1%), 149 were in Class III (48.7%), and 71 were in Class IV (23.2%). In 90% of the cases, the lesions were rheumatic in origin; the remaining cases were due to bacterial endocarditis, and congenital or ischemic lesions.
By analyzing our results, we concluded that high-risk patients with bioprosthetic mitral valves can be safely and advantageously managed with postoperative, temporary anticoagulation.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Becker R. M., Sandor L., Tindel M., Frater R. W. Medium-term follow-up of the Ionescu-Shiley heterograft valve. Ann Thorac Surg. 1981 Aug;32(2):120–126. doi: 10.1016/s0003-4975(10)61018-1. [DOI] [PubMed] [Google Scholar]
- Borkon A. M., McIntosh C. L., Von Rueden T. J., Morrow A. G. Mitral valve replacement with the Hancock bioprosthesis: five- to ten-year follow-up. Ann Thorac Surg. 1981 Aug;32(2):127–137. doi: 10.1016/s0003-4975(10)61019-3. [DOI] [PubMed] [Google Scholar]
- Craver J. M., Jones E. L., McKeown P., Bone D. K., Hatcher C. R., Jr, Kandrach M. Porcine cardiac xenograft valves: analysis of survival, valve failure, and explantation. Ann Thorac Surg. 1982 Jul;34(1):16–21. doi: 10.1016/s0003-4975(10)60846-6. [DOI] [PubMed] [Google Scholar]
- Fleming H. A., Bailey S. M. Mitral valve disease, systemic embolism and anticoagulants. Postgrad Med J. 1971 Sep;47(551):599–604. doi: 10.1136/pgmj.47.551.599. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gallo J. I., Ruiz B., Carrion M. F., Gutierrez J. A., Vega J. L., Duran C. M. Heart valve replacement with the Hancock bioprosthesis: a 6-year review. Ann Thorac Surg. 1981 May;31(5):444–449. doi: 10.1016/s0003-4975(10)60999-x. [DOI] [PubMed] [Google Scholar]
- Hetzer R., Hill J. D., Kerth W. J., Ansbro J., Adappa M. G., Rodvien R., Kamm B., Gerbode F. Thromboembolic complications after mitral valve replacement with Hancock xenograft. J Thorac Cardiovasc Surg. 1978 May;75(5):651–658. [PubMed] [Google Scholar]
- Jamieson W. R., Janusz M. T., Miyagishima R. T., Munro A. I., Tutassura H., Gerein A. N., Burr L. H., Allen P. Embolic complications of porcine heterograft cardiac valves. J Thorac Cardiovasc Surg. 1981 Apr;81(4):626–631. [PubMed] [Google Scholar]
- Lakier J. B., Khaja F., Magilligan D. J., Jr, Goldstein S. Porcine xenograft valves. Long-term (60-89-month) follow-up. Circulation. 1980 Aug;62(2):313–318. doi: 10.1161/01.cir.62.2.313. [DOI] [PubMed] [Google Scholar]
- Magilligan D. J., Jr, Lewis J. W., Jr, Tilley B., Peterson E. The porcine bioprosthetic valve. Twelve years later. J Thorac Cardiovasc Surg. 1985 Apr;89(4):499–507. [PubMed] [Google Scholar]
- Oyer P. E., Stinson E. B., Reitz B. A., Miller D. C., Rossiter S. J., Shumway N. E. Long-term evaluation of the porcine xenograft bioprosthesis. J Thorac Cardiovasc Surg. 1979 Sep;78(3):343–350. [PubMed] [Google Scholar]
- SZEKELY P. SYSTEMIC EMBOLISM AND ANTICOAGULANT PROPHYLAXIS IN RHEUMATIC HEART DISEASE. Br Med J. 1964 May 9;1(5392):1209–1212. doi: 10.1136/bmj.1.5392.1209. [DOI] [PMC free article] [PubMed] [Google Scholar]