[Late complications following heart valve replacement]

Patients with cardiac valve replacement require regular follow-up examinations since complications are not infrequent with valve prostheses. All mechanical valves are thrombogenic, only bioprostheses implanted in patients with constant sinus rhythm do not require anticoagulation. One of the most important practical tasks is the exact adjustment of anticoagulant administration in order to achieve prothrombin values of between 15 and 25%. During check-ups the physician has to pay special attention to changes in symptoms and auscultation which might point to dysfunction of the valve. Of special importance is fever of unclear origin since endocarditis of the valve is a very serious complication. The patient must be admitted to hospital at the slightest suspicion of endocarditis.