Why the study?
Does prosthetic valve replacement without elective anticoagulation result in acceptable mortality and embolism rates in children with valvular malfunction?
Does prosthetic valve replacement without elective anticoagulation result in acceptable mortality and embolism rates in children with valvular malfunction?
Prosthetic valve replacement in children can be performed with low operative mortality and acceptable long-term embolism rates without elective anticoagulation.
Answers are grounded in this paper and cite their sources.
May support no elective anticoagulation after pediatric prosthetic valves; hypothesis-generating and requires prospective confirmation.
Reported clinical experience with prosthetic valve replacement in children have suggested a high operative mortality. We placed 25 valves in 24 children with one operative death. There has been one late death related to pacemaker malfunction, but the remainder of the patients have generally done extremely well. The children have not undergone elective anticoagulation, and the long-term embolism rate has not exceeded the incidence of systemic embolization in adults who have been controlled on warfarin sodium (Coumadin) therapy. The objective of prosthetic valve replacement is myocardial preservation. We believe that valve replacement with currently available prostheses should be undertaken in any child with valvular malfunction who is not well controlled with good medical management.
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H.C. Stansel (1975) studied this question.
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