[Thromboembolic accident after mitral valve replacement].

Area of Science:

• Cardiology
• Cardiac Surgery
• Biomaterials Science

Background:

• Mitral valvular replacement (MVR) is a critical procedure for managing severe mitral valve disease.
• Bileaflet mechanical prostheses are commonly used in MVR, but carry risks of thromboembolic complications.
• Long-term outcomes and risk factors for thromboembolism following MVR with bileaflet prostheses require continued investigation.

Purpose of the Study:

• To evaluate the incidence and risk factors of thromboembolic accidents after mitral valvular replacement using bileaflet prostheses.
• To assess the long-term safety and efficacy of Saint Jude bileaflet prostheses in mitral valve replacement.

Main Methods:

• A retrospective analysis of 112 patients who underwent mitral valvular replacement with bileaflet prostheses between January 1981 and December 2000.
• Saint Jude prostheses were implanted in 71% of cases.
• Mean follow-up duration was 110 months, with detailed recording of thromboembolic events and prosthesis thrombosis.

Main Results:

• A total of 7 thromboembolic accidents (6.2%) were reported, with a linear rate of 0.69% per year.
• Embolic events occurred without prosthesis thrombosis in 6 cases; only one case of prosthesis occlusive thrombosis required urgent surgery.
• Significant predictors for thromboembolic accidents included larger left atrium size, history of embolic events, and inadequate anticoagulation.

Conclusions:

• Bileaflet prostheses demonstrate a low rate of occlusive thrombosis but a notable incidence of thromboembolic accidents.
• Left atrium size, embolic history, and anticoagulation quality are crucial factors influencing thromboembolic risk after MVR.
• Patient demographics and prosthesis type did not significantly impact the occurrence of thromboembolic events in this cohort.