Thromboembolism following Heart Valve Replacemant by Prosthesis: Survey among 365 Consecutive Patients

¹ Thoracic-Cardiovascular Surgery Department, Beilinson Hospital, University of Tel-Aviv Medical School, Petah-Tiqva, Israel

Of 365 patients operated on, 302 receiving anticoagulant therapy have been followed-up from six months to eight years. The overall incidence of systemic embolism was 15 percent. The incidence was higher in patients with mitral valve replacement as compared to those with aortic valve replacement. A trial fibrillation, preoperative emboli and atrial thrombus have been additional risk factors. The incidence of embolism has been significantly decreased following the third postoperative year, and no emboli were recorded during the sixth and seventh year of follow-up. Adequate control of anticoagulation was found effective in reducing the embolic episodes. The completely cloth covered prosthesis appears to have a lower incidence of emboli although the follow-up period so far has been too short. Of 302 patients who left the hospital following operation, 46 (13 percent) developed systemic emboli, six (2 percent) of them fatal. Only one of the 40 surviving embolism patients remained severely disabled, three moderately restricted, nine retained minor residual symptoms and 27 became asymptomatic.