ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
THROMBOSIS OF MECHANICAL MITRAL VALVES IN EARLY POSTOPERATIVE PERIOD: THE ANALYSIS OF FIVE DIFFERENT TYPES OF PROSTHESES
Veysel Kutay, *Kaan Kırali, Hasan Ekim, *Cevat Yakut
Van Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, Van
*Koşuyolu Kalp Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, İstanbul
Background: Thrombotic obstruction is an uncommon major fatal complication of the mechanical mitral valve prostheses which is leading very serious clinical results. We assessed the thrombotic occlusion and thromboembolic incidence of five different types of mechanical mitral prostheses that we had used in our clinic.

Methods: Between January 2000 and February 2003, 138 patients recieved bileaflet [(St. Jude (39), Sorin Bicarbon (41), TRI (22)] or monoleaflet [Omnicarbon (17), Bjork-Shiley (19)] mechanical mitral prostheses in Van Yüksek Ihtisas Hospital.

Results: The operative mortality (4.9% versus 5.5%, respectively) and late mortality (7.2% versus 8.8%, respectively) in bileaflet and monoleaflet groups were not significantly different. The incidences of thrombotic occlusion were 5.5%, 0%, 26.3%, 6.2%, 16.6% for St. Jude, Sorin, TRI, Omnicarbon and Bjork-Shiley, respectively. Thrombolytic treatment was given to six patients [Bileaflet (3), Monoleaflet (3)], and urgent re-operation was performed in five patients [Bileaflet (2), Monoleaflet (3)]. The mortality rates of prosthetic valve thrombosis were 2.7%, 0%, 15.7%, 0%, 11.1% for St. Jude, Sorin, TRI, Omnicarbon and Bjork-Shiley, respectively.

Conclusion: This study suggest that the thrombotic and thromboembolic incidence of TRI and Bjork-Shiley prostheses are significantly higher than the other three prostheses for postoperative 1.4 ± 0.6 year period (p < 0.01).

Keywords : Mitral valve replacement, mechanical prostheses, thrombosis, bileaflet, monoleaflet
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