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Ann Thorac Surg 1982;33:549-553
© 1982 The Society of Thoracic Surgeons

Articles

Preliminary Experience with Aspirin for Anticoagulation in Children with Prosthetic Cardiac Valves

Gerald S. Weinstein, M.D., Constantine Mavroudis, M.D., Paul A. Ebert, M.D.*

From the Department of Surgery, the University of California, San Francisco, San Francisco, CA

Accepted for publication October 29, 1981.

* Address reprint requests to Dr. Ebert, University of California, San Francisco, Department of Surgery, M 488, San Francisco, CA 94143

Twenty-four children (ages 1 to 18 years, mean 12.2 years) underwent 27 operations for aortic, mitral, or combined aortic and mitral valve replacement. There was 1 operative death. Of the 23 operative survivors (12 aortic, 8 mitral, 3 combined valve replacement), only 5 were given warfarin for long-term anticoagulation. The remaining 18 (10 aortic, 8 mitral valve replacement) were given aspirin (plus dipyridamole in 5). Twelve of the 18 had at least one mechanical valve (11 Björk-Shiley and Beall valves; 1 Björk-Shiley valve was replaced with a Beall disc valve as the child grew).

These 18 patients were followed for 1 to 59 months (mean, 20.4 months). There was no thrombotic, embolic, or bleeding complications. There were 2 late deaths (one cardiac).

Review of the available literature indicates that in children with prosthetic cardiac valves, aspirin (with or without dipyridamole) provides adequate protection against thromboemboli and avoids the hemorrhagic complications associated with warfarin.




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