Abstract
Twenty-five consecutive pediatric patients underwent the insertion of 27 ST. JUDE MEDICAL® valves in a nonrandomized clinical trial. All were managed with aspirin and PERSANTINE® postoperatively. Five thromboembolic events (TE) were observed in the 25 patients during a total of 199 patient-months of follow-up. This represents a 20% TE incidence and extrapolates to 30.1 TE events per 100 patient-years. Based on these data, all children are now placed on COUMADIN® therapy. We recommend COUMADIN anticoagulation in all children with the ST. JUDE MEDICAL valve and suggest a cooperative multicenter trial to help resolve the issue.
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References
Gardner TJ, Roland JMA, Neill CA, et al: Valve replacement in children: A fifteen year experience. J Thorac Cardiovasc Surg 1982; 83, 178–185.
Donahoo JS, Gardner TJ: St. Jude Medical valve prostheses in infants and children. S Med J 1982; 75, 1538–1540.
Human G., Jaffe HS, Fraser CB, et al: Mitral valve replacement in children. J Thorac Cardiovasc Surg 1982; 83, 873–877.
Lomeo A, Patene L, Gentile M, et al: Aortic valve replacement with St. Jude valve without long term anticoagulants: A prospective study, in DeBakey ME (ed): Advances in Cardiac Valves: Clinical Perspectives, New York, Yorke Medical Books, 1983, pp 170–172.
Pass HI, Sade RM, Crawford FA, et al: St. Jude Prostheses without anticoagulation in Children. Am J Card 1982; 49, 1035.
Smith JM, Cooley DA, Ott DA, et al: Aortic valve replacement in preteenage children. Ann Thorac Surg 1980; 29, 512–518.
Geha AS: Valve replacement in children. Ann Thorac Surg 1980; 29, 500–501.
Baudet EM: Cardiac valve replacement in children with St. Jude Medical prosthesis, in DeBakey ME (ed): Advances in Cardiac Valves: Clinical Perspectives, New York, Yorke Medical Books, 1983, pp 149–155.
Nicoloff DM, Arom KV, Lindsay WG, et al: Techniques for implantation of the St. Jude valve in the aortic and mitral positions, in Debakey ME (ed): Advances in Cardiac Valves: Clinical Perspectives. New York, Yorke Medical Books, 1983, pp 191–196.
Williams WG, Pollock JC, Geiss DM, et al: Experience with aortic and mitral valve replacement in children. J Thorac Cardiovasc Surg 1981; 81: 326–333.
Matthews RA, Park SC, Neches WH, et al: Valve replacement in children and adolescents. J Thorac Cardiovasc Surg 1977; 73: 872–878.
Geha AS, Laks H, Stansel HC et al: Late failure of porcine valve heterografts in children. J Thorac Cardiovasc Surg 1979; 78: 351–364.
Wada J, Yokoyama M, Hashimoto A, et al: Long term followup of artificial heart valves in patients under 15 years old. Ann Thorac Surg 1979; 29: 519–520.
Dunn JM: Porcine valve durability in children. Ann Thorac Surg 1981; 32: 357–368.
Williams WG, Pollock JC, Geiss DM, et al: Experience with aortic and mitral valve replacement in children. J Thorac Cardiovasc Surg 1981; 81: 326–333.
Fiddler GI, Gerlis LM, Walker DR, et al: Calcification of glutaraldehyde-preserved porcine and bovine xenograft valves in young children. Ann Thorac Surg 1983; 35: 257–261.
Walker WE, Duncan JM, Frazier OH, et al: Early experience with the Ionescu-Shiley pericardial xenograft valve: Accelerated calcification in children. J Thorac Cardiovasc Surg 1983; 86: 570–575.
Crupi G, Gibson D, Heard B, et al: Severe late failure of a porcine xenograft mitral valve: Clinical, echocardiographic and pathological findings. Thorax 1980; 35: 210–212.
Cuicio CA, Commerford PJ, Rose AG, et al: Calcification of glutaraldehyde-perserved porcine xenografts in young patients. J Thorac Cardiovasc Surg 1981; 81: 621–625.
Lillehei CW: Worldwide experience with the St. Jude Medical valve prosthesis: Clinical and hemodynamic results. Contemp Surg 1982; 20: 17–32.
Wortham DC, Tri TB, Bowen TE: Hemodynamic evaluation of the St. Jude Medical valve prosthesis in the small aortic annulus. J Thorac Cardiovasc Surg 1981; 81: 615–620.
Nicoloff DM, Emery RW, Arom KV, et al: Clinical and hemodynamic results with the St. Jude Medical cardiac valve prosthesis. J Thorac Cardiovasc Surg 1981; 82: 674–683.
Chaux A, Gray RG, Matloff JM, et al: An appreciation of the new St. Jude valvular prosthesis. J Thorac Cardiovasc Surg 1981; 81: 202–211.
Moggio RA, Hammond GL, Stansel HC, et al: Incidence of emboli with cloth-covered Starr-Edwards valve without anticoagulation and with varying forms of anticoagulation. J Thorac Cardiovasc Surg 1978; 75: 296–299.
St. John Sutton MG, Miller GAH, Oldershaw PJ, et al: Anticoagulants and the Bjork-Shiley prosthesis: Experience of 390 patients. Br Heart J 1978; 40: 558–562.
Nunez L, Aguado MG, Celemin D, et al: Aspirin or Coumadin as the drug of choice for valve replacement with porcine bioprosthesis. Ann Thorac Surg 1982; 33: 354–358.
Horstkotte D, Korfer R, Seipel L, et al: Late complications in patients with Bjork-Shiley and St. Jude Medical heart valve replacement. Circulation 1983; 68 (Supp II):11-175–11-184.
Nunez L, Iglesias A, Sotillo J: Entrapment of leaflet of St. Jude Medical cardiac valve prosthesis by miniscule thrombus: Report of two cases. Aim Thorac Surg 1980; 29: 567–569
Sharma A, Johnson DC, Cartmill TB: Entrapment of both leaflets of St. Jude Medical aortic valve prosthesis in a child. J Thorac Cardiovasc Surg 1983; 86: 453–454.
Moulton AL, Singleton RT, Oster WF, et al: Fatal thrombosis of an aortic St. Jude Medical valve despite “adequate” anticoagulation. J Thorac Cardiovasc Surg 1982; 83: 472–473.
Subramanian S: Use of the St. Judge Medical prosthesis in children, in DeBakey ME (ed): Advances in Cardiac Valves: Clinical Perspectives. New York, Yorke Medical Books, 1983; pp 129–137.
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© 1985 Martinus Nijhoff Publishing, Boston
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Boe, S.L., Mcnicholas, K.W., Olivier, H.F., Niguidula, F.N., Magovern, G.J., Lemole, G.M. (1985). Thromboembolism in Children with ST. JUDE MEDICAL® Valves Maintained on Aspirin and PERSANTINE® . In: Matloff, J.M. (eds) Cardiac Valve Replacement. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2601-4_18
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DOI: https://doi.org/10.1007/978-1-4613-2601-4_18
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