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Ann Thorac Surg 1995;60:1312-1316
© 1995 The Society of Thoracic Surgeons

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Original Articles: Cardiovascular

Ball Valve (Smeloff-Cutter) Aortic Valve Replacement Without Anticoagulation

Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Accepted for publication June 17, 1995.

Background. Because of the difficulty of permanent anticoagulation in our young population, Smeloff-Cutter ball valves have been used since 1986 at our institution for aortic valve replacement in selected patients without permanent anticoagulation therapy.

Methods. The availability of a satisfactory follow-up system since July 1988 suggested a study of all 47 patients operated on since then and followed for a mean of 43.2 months (range, 16 to 78 months). Mean age was 26.3 years, 98% were in sinus rhythm, and 16 patients (34%) had concomitant mitral repair.

Results. There were no hospital deaths. Three patients were lost to follow-up at a mean of 27 months. Four late deaths occurred (8.5%), two of them sudden, with actuarial survival at 6 years of 91% ± 4.3%. There were a total of five embolic events (2.9%/patient-year). For isolated aortic valve replacement only, with antiaggregant therapy (n = 29), the incidence was 0.9%/patient-year. For all patients receiving antiaggregant agents (n = 43), it was 3.02%/patient-year. There were no known cases of valve thrombosis. Reoperation was required in 5 patients.

Conclusion. Aortic valve replacement with the Smeloff-Cutter ball valve might be a valid alternative for young patients unable to maintain regular anticoagulation.

Related Article

Invited Commentary

Edward A. Smeloff
Ann. Thorac. Surg. 1995 60: 1316. [Extract] [Full Text]

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