Medium-term follow-up of the Ionescu-Shiley heterograft valve.
Utilizing a questionnaire specifically designed to uncover potential thromboembolic episodes, we personally interviewed 97 patients who underwent valve replacement with the Ionescu-Shiley valve between January, 1977, and June, 1980. In both the aortic and mitral positions, the attrition rate after the first year was low; cumulative survival at 3 to 4 years was 78% (aortic) and 61% (mitral). None of the deaths were attributed to primary valve failure. Patients with aortic prostheses, none of whom were anticoagulated, had a cumulative thromboembolism-free rate of 94% at 3 to 4 years. Patients with mitral prostheses had a thromboembolism-free rate of 71% at 3 to 4 years with 80% of the episodes occurring in patients in atrial fibrillation. Most emboli produced only transient symptoms, and only 1 patient has residual impairment. The Ionescu-Shiley valve performs well in the early years after valve replacement. Anticoagulation should be strongly considered for patients with mitral prostheses who are in atrial fibrillation.
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D011795:Surveys and Questionnaires; D013923:Thromboembolism / Q000401:mortality / Q000517:prevention & control
D000925:Anticoagulants