Long-term survival and complications in patients with mechanical aortic valves without anticoagulation. A follow-up study from 1 to 15 years

• Published in: European journal of cardio-thoracic surgery Vol. 6; no. 2; pp. 62 - 65
• Main Authors: ANDERSEN, P. V, ALSTRUP, P
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 1992; Elsevier Science
• Subjects: Adolescent; Adult; Aged; Aortic Valve; Biological and medical sciences; Cardiology. Vascular system; Endocardial and cardiac valvular diseases; Female; Follow-Up Studies; Heart; Heart Valve Prosthesis - adverse effects; Heart Valve Prosthesis - mortality; Humans; Male; Medical sciences; Middle Aged; Prognosis; Retrospective Studies; Survival Rate; Thromboembolism - etiology; Thromboembolism - mortality; Time Factors; Human; Postoperative; Cardiac valvular disease; Follow up study; Surgery; Cardiovascular disease; Complication; Replacement; Survival; Aortic valve
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/1010-7940(92)90076-A

In aortic valve replacement most centres prefer to use a mechanicalvalve for younger patients without special bleeding risks and treat thepatient with lifelong anticoagulation. However, a few patients do notreceive anticoagulation at all or have this withdrawn after some time. Weexamined the prognosis of 43 patients, 37 men and 6 women (mean age 52years), who were treated with anticoagulation for approximately only 1 year(mean 13 months; range 4-35 months) after isolated aortic valve replacementwith 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 ofthromboembolic events of 5.2%/pt-yr, valve- related events of 6.2%/pt-yrand death of 2.9%/pt-yr. We conclude that the best postoperative treatmentin isolated aortic valve replacement with a mechanical valve is lifelonganticoagulation.