MITRAL MECHANICAL VALVE WITHOUT LONG-TERM ANTICOAGULATION - 8-YEAR FOLLOW-UP

In 12 patients with sinus rhythm (including 5 children and 6 young wom en), mitral valve replacement was performed with a microporous-surface d valve similar to the Bjork-Shiley Monostrut. After the first 3 month s, permitting endothelialization of the suture ring to continue over t he groove and adjacent metal valve ring, no long-term anticoagulant tr eatment was given. There was no thromboembolic complication in this gr oup during followup for 6-8 years, during which four women gave birth to a total of seven children. In eight other cases, one mitral case wi th atrial fibrillation, anti-coagulant was not discontinued, and in th e remaining aortic cases it was reinstituted. One of them (with atrial fibrillation) had hematuria during inadequate anticoagulant medicatio n, but no thromboembolism. Of five patients with only aortic valve rep lacement, two had thromboembolic complications, one without residual s ymptoms and one with slight hand weakness. Another had a transient isc hemic attack while on anticoagulant and acetylsalicylic acid was added . Two patients with aortic and mitral valve replacement died, one from heart tamponade and the other from venous thrombosis with pulmonary e mbolism.