TY - JOUR
T1 - Recurrent systemic embolic events with valve prosthesis
AU - Acar, J.
AU - Enriquez-Sarano, M.
AU - Farah, E.
AU - Kassab, R.
AU - Tubiana, P.
AU - Roger, V.
PY - 1984
Y1 - 1984
N2 - 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.
AB - 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.
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U2 - 10.1093/eurheartj/5.suppl_d.33
DO - 10.1093/eurheartj/5.suppl_d.33
M3 - Article
C2 - 6519099
AN - SCOPUS:0021747468
SN - 0195-668X
VL - 5
SP - 33
EP - 38
JO - European heart journal
JF - European heart journal
IS - SUPPL. D
ER -