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Ann Thorac Surg 1977;23:529-533
© 1977 The Society of Thoracic Surgeons

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Articles

Thromboembolic Complications with the Cloth-Covered Starr-Edwards Aortic Prosthesis in Patients Not Receiving Anticoagulants

From the Department of Surgery, Montreal Heart Institute, Montreal, Que, Canada

Accepted for publication October 15, 1976.

^* Address reprint requests to Dr. Claude M. Grondin, Montreal Heart Institute, 5000 E Belanger St, Montreal, Que, Canada HIT 1C8

A comparison of the incidence of thromboembolic (TE) episodes was made in three groups of patients 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.

This article has been cited by other articles:

				M. H. Eckman, J. R. Beshansky, I. Durand-Zaleski, H. J. Levine, and S. G. Pauker Anticoagulation for Noncardiac Procedures in Patients With Prosthetic Heart Valves: Does Low Risk Mean High Cost? JAMA, March 16, 1990; 263(11): 1513 - 1521. [Abstract] [PDF]

				L. H. Edmunds Jr. Thromboembolic Complications of Current Cardiac Valvular Prostheses Ann. Thorac. Surg., July 1, 1982; 34(1): 96 - 106. [Abstract] [PDF]