The Annals of Thoracic Surgery, Vol 23, 529-533, Copyright © 1977 by The Society of Thoracic Surgeons
Thromboembolic complications with the cloth-covered Starr-Edwards aortic prosthesis in patients not receiving anticoagulants
R Limet, G Lepage and CM Grondin
A comparison of the incidence of thromboembolic (TE) episodes was made in
three groups of patient who underwent aortic valve replacement with the
cloth-covered Starr-Edwards prostheses. Group 1 consisted of patients who
received anticoagulants for either the entire period of follow-up or for a
period of variable duration, after which these agents were no longer
administered. When anticoagulants were stopped, 22 patients were
categorized as Group 3 for study. Group 2 comprised patients who never
received anticoagulants. Of the 147 patients followed in Group 1, 14
suffered one episode of TE. Six patients experienced major emboli; 3 of
them died. Twenty of the 82 patients followed in Group 2 (no
anticoagulants) suffered TE complications. There were 10 episodes of major
emboli. Five of the 22 patients in Group 3 suffered an episode (all major)
of TE. It is concluded from this study that anticoagulants should be given
permanently to all patients with cloth-covered Starr-Edwards prostheses.
Indeed, there is no period after operation when the incidence of TE is so
low that anticoagulation may be safely discontinued.
