Mitral mechanical valve without long-term anticoagulation. Eight-year follow-up.
In 12 patients with sinus rhythm (including 5 children and 6 young women), mitral valve replacement was performed with a microporous-surfaced valve similar to the Björk-Shiley Monostrut. After the first 3 months, permitting endothelialization of the suture ring to continue over the groove and adjacent metal valve ring, no long-term anticoagulant treatment was given. There was no thromboembolic complication in this group during follow-up for 6-8 years, during which four women gave birth to a total of seven children. In eight other cases, one mitral case with atrial fibrillation, anti-coagulant was not discontinued, and in the remaining aortic cases it was reinstituted. One of them (with atrial fibrillation) had hematuria during inadequate anticoagulant medication, but no thromboembolism. Of five patients with only aortic valve replacement, two had thromboembolic complications, one without residual symptoms and one with slight hand weakness. Another had a transient ischemic attack while on anticoagulant and acetylsalicylic acid was added. Two patients with aortic and mitral valve replacement died, one from heart tamponade and the other from venous thrombosis with pulmonary embolism.
Björk
V O
VO
Hospital dos Servidores do Estado, Rio de Janeiro, Brazil.
Ribeiro
A
A
Canetti
M
M
Bomfim
V
V
D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000188:drug therapy / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000379:methods; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008943:Mitral Valve; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control; D011474:Prosthesis Design; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin