Long-term survival and complications in patients with mechanical aortic valves without anticoagulation. A follow-up study from 1 to 15 years.
In aortic valve replacement most centres prefer to use a mechanical valve for younger patients without special bleeding risks and treat the patient with lifelong anticoagulation. However, a few patients do not receive anticoagulation at all or have this withdrawn after some time. We examined the prognosis of 43 patients, 37 men and 6 women (mean age 52 years), who were treated with anticoagulation for approximately only 1 year (mean 13 months; range 4-35 months) after isolated aortic valve replacement with a mechanical valve. The mean follow-up period was 7 years and 3 months (1.5 months to 15 years and 10 months). After 5 and 10 years, 70% and 59%, respectively, were free of thromboembolic events, 65% and 55%, respectively, were free of valve-related events, and 87% and 83%, respectively, had survived. These figures correspond to linearized rates of thromboembolic events of 5.2%/pt-yr, valve-related events of 6.2%/pt-yr and death of 2.9%/pt-yr. We conclude that the best postoperative treatment in isolated aortic valve replacement with a mechanical valve is lifelong anticoagulation.
Andersen
P V
PV
Department of Cardio-thoracic Surgery, Odense University Hospital, Denmark.
Alstrup
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013923:Thromboembolism / Q000209:etiology* / Q000401:mortality; D013997:Time Factors