Thromboembolic Phenomena in Patients with Prosthetic Aortic Valves Who Did Not Receive Anticoagulants

Larsen, Gordon L.; Alexander, James A.; Stanford, William

doi:10.1016/s0003-4975(10)64133-1

Cited by 29 publications

(3 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The degree of risk is influenced by type of valve, valve site, and the presence of comorbid conditions such as atrial fibrillation. 3 With the use of anticoagulants, the rate of systemic embolism has been reduced substantially to 1-3% per year. 4 The current recommendation of the American College of Chest Physicians is that patients with mechanical heart valves receive warfarin for anticoagulation to maintain the international normalized ratio (INR) between 2.5 and 3.5.…”

Section: Discussionmentioning

confidence: 99%

Successful Anticoagulation with Dalteparin in a Patient with Mechanical Heart Valves

1999

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Successful Anticoagulation with Dalteparin in a Patient with Mechanical Heart Valves

1999

View full text Add to dashboard Cite

show abstract

“…In the aortic position (Table 3) Table 4 Thromboembolism older ball valve prostheses had shown a thromboembolic rate of up to 6 per 100 patient years on anticoagulants (52,67). This incidence was markedly reduced by cloth-covering in most studies (24,27,40,67). In fact non-anticoagulated patients were now subjected to a risk of thromboembolism equal to that of patients with older ball valves receiving dicoumarol.…”

Section: Jones 1978mentioning

confidence: 99%

Cardiac Valve Replacement. Problems Solved and Unsolved

Hg¹,

Papagiannakis²,

Bedderman³

et al. 1979

Thorac cardiovasc Surg

View full text Add to dashboard Cite

In this review the present state of cardiac valve replacement is summarized on the basis of the literature and personal experience in approximately 1500 cases, using various prosthetic models. Durability, hemodynamic performance at rest and during exercise, and thromboembolic risk are considered in particular and our choice of the various valve models is discussed on these grounds. The long-term durability has been significantly improved and has possibly been solved in the more advanced mechanical valves, while this question is still open in the present biological prostheses. Hemodynamic performance is considered less than optimal in all conventional mechanical prostheses and in the xenografts. Pressure gradients are abnormal in all mechanical as well as in stented biological prostheses, the latter being less likely to solve the problem of a narrow aortic root. The significantly lower incidence of thromboembolism and total valve thrombosis and the absence of anticoagulation accidents in patients with bioprostheses has tipped the balance for the present in favor of the latter, particularly in mitral valve replacement and certainly in all those patients in whom anticoagulation in impossible, unlikely, or undesirable.

show abstract

“…Most authors agree that patients with a prosthetic mitral valve must continue longterm anticoagulants, but in recent years some studies have shown that patients may do well without anticoagulants after aortic valve replacement (4,5,13). In contrast to these studies, other authors have experienced disappointing results without anticoagulants (2,8,11,12). In light of these results we find it of interest to present our experiences concerning aortic valve replacement with the Lillehei-Kaster pivoting disc valve, using initial anticoagulant therapy, discontinued after 6 or 12 months.…”

mentioning

confidence: 99%

Thromboembolism in Patients without Anticoagulants after Aortic Valve Replacement with the Lillehei-Kaster Disc Valve

Pb¹,

Alstrup²

1979

Thorac cardiovasc Surg

View full text Add to dashboard Cite

In a 5-year period 52 consecutive patients underwent aortic valve replacement with the Lillehei-Kaster pivoting disc prosthesis. Forty-four patients surviving more than one year after the operation were followed up to determine the incidence of thromboembolism and hemorrhage. In group I 24 patients with a mean observation time of 24.9 months (range 2-60) had anticoagulants discontinued 6 or 12 months postoperatively and showed a thromboembolic rate of 8.0 per 100 patient-years and a hemorrhagic rate of 2.0 per 100 patient-years. Group II contained 23 patients with a mean observation time of 16.3 months (range 2-44) and showed a thromboembolic rate of 6.4 per 100 patientyears and a hemorrhagic rate of 9.6 per 100 patient-years. Patients, who suffered a thromboembolic episode, showed a mean postoperative valve gradient of 37 mmHg, significantly higher than the mean postoperative valve gradient of 17 mmHg for the rest of the patients. The thromboembolic risk showed no clear-cut tendency to decline with time. No thrombotic encapsulation of the prosthesis was found. No clear correlation between hemorrhages and prothrombinproconvertin time was found. The actuarial 5-year survival rate for patients leaving hospital was 77.3 %.

show abstract

Thromboembolic Phenomena in Patients with Prosthetic Aortic Valves Who Did Not Receive Anticoagulants

Cited by 29 publications

References 7 publications

Successful Anticoagulation with Dalteparin in a Patient with Mechanical Heart Valves

Successful Anticoagulation with Dalteparin in a Patient with Mechanical Heart Valves

Cardiac Valve Replacement. Problems Solved and Unsolved

Thromboembolism in Patients without Anticoagulants after Aortic Valve Replacement with the Lillehei-Kaster Disc Valve

Contact Info

Product

Resources

About