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. 1978 May;40(5):558–562. doi: 10.1136/hrt.40.5.558

Anticoagulants and the Björk-Shiley prosthesis. Experience of 390 patients.

M G Sutton, G A Miller, P J Oldershaw, M Paneth
PMCID: PMC483445  PMID: 656224

Abstract

From September 1972 to January 1975, 390 patients underwent valve replacement using the Björk-Shiley tilting disc prosthesis. For the group as a whole hospital mortality was 13.3 per cent and was lowest in those undergoing isolated mitral or aortic valve replacement (5.3 and 9.4%, respectively). Available for follow-up were 209 patients of whom 123 were maintained on dipyridamole and 96 on warfarin. Thromboembolic complications were significantly (P less than 0.01) commoner in the dipyridamole (28 of 123, 22%) than warfarin (6 of 86, 7%) treated group. In the dipyridamole treated group the incidence of thromboembolic complications was similar whichever valve was replaced and thromboembolic complications were responsible for 14 of the 28 late deaths. In the warfarin treated group thromboembolic complications only occurred in patients with a mitral prosthesis. Anticoagulation is indicated for all patients with this prosthesis wherever inserted.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arrigoni M. G., Danielson G. K., Mankin H. T., Pluth J. R. Aortic valve replacement with cloth-covered composite-seat Starr-Edwards prosthesis. A review of 32 months of clinical experience. J Thorac Cardiovasc Surg. 1973 Mar;65(3):376–380. [PubMed] [Google Scholar]
  2. Björk V. O., Bök K., Cernigliaro C., Holmgren A. The Björk-Shiley tilting disc valve in isolated mitral lesions. Scand J Thorac Cardiovasc Surg. 1973;7(2):131–148. doi: 10.3109/14017437309135555. [DOI] [PubMed] [Google Scholar]
  3. Björk V. O., Henze A. Encapsulation of the Björk-Shiley aortic disc valve prosthesis caused by the lack of anticoagulant treatment. Scand J Thorac Cardiovasc Surg. 1973;7(1):17–20. doi: 10.3109/14017437309139160. [DOI] [PubMed] [Google Scholar]
  4. Björk V. O., Henze A. Management of thrombo-embolism after aortic valve replacement with the Björk-Shiley tilting disc valve. Medicamental prevention with dicumarol in comparison with dipyridamole - acetylsalicylic acid. Surgical treatment of prosthetic thrombosis. Scand J Thorac Cardiovasc Surg. 1975;9(3):183–191. doi: 10.3109/14017437509138637. [DOI] [PubMed] [Google Scholar]
  5. Björk V. O., Holmgren A., Olin C., Ovenfors C. O. Clinical and haemodynamic results of aortic valve replacement with the Björk-Shiley tilting disc valve prosthesis. Scand J Thorac Cardiovasc Surg. 1971;5(3):177–191. [PubMed] [Google Scholar]
  6. Bonchek L. I., Starr A. Ball valve prostheses: current appraisal of late results. Am J Cardiol. 1975 Jun;35(6):843–854. doi: 10.1016/0002-9149(75)90121-6. [DOI] [PubMed] [Google Scholar]
  7. Bonchek L. I., Starr A. Late results of mitral and aortic valve replacement. Isr J Med Sci. 1975 Feb-Mar;11(2-3):152–160. [PubMed] [Google Scholar]
  8. Braunwald N. S., Detmer D. E. A critical analysis of the status of prosthetic valves and homografts. Prog Cardiovasc Dis. 1968 Sep;11(2):113–132. doi: 10.1016/0033-0620(68)90022-4. [DOI] [PubMed] [Google Scholar]
  9. Cucuianu M. P., Nishizawa E. E., Mustard J. F. Effect of pyrimido-pyrimidine compounds on platelet function. J Lab Clin Med. 1971 Jun;77(6):958–974. [PubMed] [Google Scholar]
  10. Dale J., Myhre E., Rootwelt K. Effects of dipyridamole and acetylsalicylic acid on platelet functions in patients with aortic ball-valve prostheses. Am Heart J. 1975 May;89(5):613–618. doi: 10.1016/0002-8703(75)90507-4. [DOI] [PubMed] [Google Scholar]
  11. Didisheim P. Inhibition by dipyridamole of arterial thrombosis in rats. Thromb Diath Haemorrh. 1968 Nov 15;20(1):257–266. [PubMed] [Google Scholar]
  12. Emmons P. R., Harrison M. J., Honour A. J., Mitchell J. R. Effect of dipyridamole on human platelet behaviour. Lancet. 1965 Sep 25;2(7413):603–606. doi: 10.1016/s0140-6736(65)90515-5. [DOI] [PubMed] [Google Scholar]
  13. Friedli B., Aerichide N., Grondin P., Campeau L. Thromboembolic complications of heart valve prostheses. Am Heart J. 1971 May;81(5):702–708. doi: 10.1016/0002-8703(71)90015-9. [DOI] [PubMed] [Google Scholar]
  14. Gadboys H. L., Litwak R. S., Niemetz J., Wisch N. Role of anticoagulants in preventing embolization from prosthetic heart valves. JAMA. 1967 Oct 23;202(4):282–286. [PubMed] [Google Scholar]
  15. Harker L. A., Slichter S. J. Studies of platelet and fibrinogen kinetics in patients with prosthetic heart valves. N Engl J Med. 1970 Dec 10;283(24):1302–1305. doi: 10.1056/NEJM197012102832402. [DOI] [PubMed] [Google Scholar]
  16. STARR A., EDWARDS M. L. Mitral replacement: clinical experience with a ball-valve prosthesis. Ann Surg. 1961 Oct;154:726–740. doi: 10.1097/00000658-196110000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. St John Sutton M. G., Traill T. A., Ghafour A. S., Brown D. J., Gibson D. G. Echocardiographic assessment of left ventricular filling after mitral valve surgery. Br Heart J. 1977 Dec;39(12):1283–1291. doi: 10.1136/hrt.39.12.1283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Sullivan J. M., Harken D. E., Gorlin R. Pharmacologic control of thromboembolic complications of cardiac-valve replacement. N Engl J Med. 1971 Jun 24;284(25):1391–1394. doi: 10.1056/NEJM197106242842501. [DOI] [PubMed] [Google Scholar]

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