Mitral Mechanical Valve Without Long-Term Anticoagulation: Eight-year Follow-up

Abstract

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.

Mechanical mitral valves without long-term anticoagulation up tothirteen years

“…We operated on a small group of 12 patients 11 and 13 years ago. 5 All these patients had sinus rhythm. There were 5 children aged 7 to 15 years with mitral insufficiency and cardiomegaly.…”

“…There were 5 children aged 7 to 15 years with mitral insufficiency and cardiomegaly. 5 Patient 10 was cachectic and needed enteral nutrition for weeks before the operation. An 8-year-old boy (case 9) had a severe form of sickle cell anemia, with a hemoglobin S value of 95%, and required exchange transfusion before the operation.…”