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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Hematological complications with the St. Jude valve and reduced-dose Coumadin
The Annals of thoracic surgery, v 48(2), 280
01 Aug 1989
PMID: 2764619
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
We examined hematological complications in 415 patients having valve replacement with the St. Jude mechanical prosthesis (212, aortic valve replacement [AVR]; 159, mitral valve replacement [MVR]; and 44, AVR + MVR). There were 164 men and 251 women with a mean age of 59 years (range, 20 to 88 years). Preoperatively 386 patients were in New York Heart Association functional classes III and IV. There were 154 associated procedures (37%), the most common being myocardial revascularization. Overall hospital mortality was 7.5% (
31
/
415
), 7% alter AVR, 8% after MVR, and 7% after AVR + MVR. All operative survivors were anticoagulated with Coumadin (crystalline warfarin sodium) to maintain the prothrombin time at 1.5 times control. During a mean follow-up of 21 months (range, 6 to 60 months), there were 29 late deaths (7.6%) and 5 patients (1.3%) lost to follow-up. No patient experienced structural valve degeneration. At 48 months, actuarial freedom from thromboembolism was 87% ± 3% after AVR and 91% ± 9% after MVR; front anticoagulation-related hemorrhage, 97% ± 3% after AVR and 91% ± 3% after MVR; and from hemolysis, 100% after AVR and 98% ± 2% after MVR. Freedom from all valve-related morbidity at 4 years was 82% ± 5% after AVR and 75% ± 10% after MVR. Actuarial survival at 48 months was 80% ± 4% after AVR and 65% ± 7% after MVR.
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Details
- Title
- Hematological complications with the St. Jude valve and reduced-dose Coumadin
- Creators
- Verdi J. DiSesa - Brigham and Women's HospitalJohn J. Collins - Brigham and Women's HospitalLawrence H. Cohn - Brigham and Women's Hospital
- Publication Details
- The Annals of thoracic surgery, v 48(2), 280
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:A1989AM41000026
- Scopus ID
- 2-s2.0-0024323646
- Other Identifier
- 991021463420004721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery