dicumarol and Heart-Valve-Diseases

Topics: Adolescent; Aortic Valve; Bioprosthesis; Child; Dicumarol; Female; Follow-Up Studies; Heart Valve Diseases; Heart Valve Prosthesis; Hemodynamics; Hemorrhage; Humans; Male; Mitral Valve; Postoperative Complications; Prosthesis Design; Prosthesis Failure; Thromboembolism

Topics: Adult; Atrial Fibrillation; Bioprosthesis; Calcinosis; Cardiac Output, Low; Dicumarol; Female; Follow-Up Studies; Heart Valve Diseases; Heart Valve Prosthesis; Humans; Male; Middle Aged; Mitral Valve; Postoperative Complications; Prosthesis Design; Risk; Thromboembolism; Thrombosis

Twenty-four children (ages 1 to 18 years, mean 12.2 years) underwent 27 operations for aortic, mitral, or combined aortic and mitral valve replacement. There was 1 operative death. Of the 23 operative survivors (12 aortic, 8 mitral, 3 combined valve replacement), only 5 were given warfarin for long-term anticoagulation. The remaining 18 (10 aortic, 8 mitral valve replacement) were given aspirin (plus dipyridamole in 5). Twelve of the 18 had at least one mechanical valve (11 Björk-Shiley and Beall valves; 1 Björk-Shiley valve was replaced with a Beall disc valve as the child grew). These 18 patients were followed for 1 to 59 months (mean, 20.4 months). There was no thrombotic, embolic, or bleeding complications. There were 2 late deaths (one cardiac). Review of the available literature indicates that in children with prosthetic cardiac valves, aspirin (with or without dipyridamole) provides adequate protection against thromboemboli and avoids the hemorrhagic complications associated with warfarin.

Topics: Adolescent; Anticoagulants; Aortic Valve; Aspirin; Bioprosthesis; Child; Child, Preschool; Dicumarol; Dipyridamole; Drug Therapy, Combination; Heart Valve Diseases; Heart Valve Prosthesis; Humans; Infant; Mitral Valve; Postoperative Complications; Retrospective Studies; Thromboembolism; Warfarin

Topics: Angina Pectoris; Anticoagulants; Aspirin; Dicumarol; Disseminated Intravascular Coagulation; Electric Countershock; Heart Valve Diseases; Humans; Myocardial Infarction; Pulmonary Embolism; Thrombophlebitis; Thrombosis; Warfarin

Topics: Anticoagulants; Coronary Disease; Dicumarol; Heart Defects, Congenital; Heart Valve Diseases; Intracranial Arteriosclerosis; Phlebitis; Pulmonary Emphysema; Thromboembolism; Toxicology; Vascular Diseases; Warfarin

Topics: Anticoagulants; Dicumarol; Heart Valve Diseases; Hemiplegia; Humans; Mitral Valve