Recurrent systemic embolic events with valve prosthesis

J. Acar, M. Enriquez-Sarano, E. Farah, R. Kassab, P. Tubiana, V. Roger

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Among 1436 patients who underwent valve replacement, the 400 first cases were studied to assess the features of recurrent systemic embolic event. The mean follow-up was 87 months. Three groups of patients were compared: group A - 289 patients without any thromboembolic event (72.25%); group B - 78 patients with only one embolic event (19.5%); group C - 33 patients with several embolic events (8.25%). The frequency of recurrence was high; one patient out of three (linearized mean 8.9% in group C considering only one recurrence, vs 3.8% in group B). The recurrence have the same location in 45% of patients. The consequences of these embolisms are serious; each event has a 30 to 40% risk of death or major disability. Four variables seem statistically to promote the occurrence of embolic events: mitral prostheses, pre-operative fibrillation, left atrial enlargement, poor anticoagulant therapy. 54 months after thromboembolism vs 20% with adequate therapy. Twenty-six patients of groups B and C had a pathological study of prostheses. Thrombosis of the prostheses was found in 12 out of 18 patients in group B and in 7 out of 8 patients; in group C. Strict observance of anticoagulant therapy is the better way to prevent thromboembolism and especially recurrences. A reoperation is sometimes necessary. Valve re-replacement was performed in 27 cases out of 1436 patients.

Original languageEnglish (US)
Pages (from-to)33-38
Number of pages6
JournalEuropean heart journal
Volume5
Issue numberSUPPL. D
DOIs
StatePublished - 1984

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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