Lillehei-Kaster prosthesis in the aortic position with and without anticoagulants

Sixty-two patients after aortic valve replacement were given aspirin in place of anticoagulants post operatively. This group is compared with another of 125 patients receiving anticoagulants. In the former group there was one instance of valve thrombosis, five of transient embolic episodes and six late deaths. In the latter group there were two instances of valve thrombosis--both occurring when the anticoagulation was inadequate, one embolic episode and six late deaths. Anticoagulant therapy is recommended for all patients with the Lillehei-Kaster prosthesis. However, where anticoagulants cannot be used control with aspirin is nearly as effective, but with a somewhat higher risk. Long-term results with Lillehei-Kaster valves as regards survival and thromboembolism compare favourably with all contemporary mechanical prostheses and porcine heterografts.