Management of patients with prosthetic heart valves

Regina Jonkaitienė, Rimantas Benetis, Renata Eidukaitytė

Heart Centre, Kaunas University of Medicine, Lithuania

Key words: prosthetic valves, antithrombotic therapy, follow up.

Summary. The amount of patients with prosthetic valves is increasing and their follow up is an actual problem. The aim of this study was to estimate postoperative complications after valve replacement and to give the follow up schedule for family doctors and cardiologist.

The article demonstrates late postoperative results of valve replacements performed in Heart Centre of Kaunas University of Medicine during five years (1999–2003). Hemodynamics, auscultation of patients with prosthetic valves, antithrombotic treatment, specificity of anticoagulants use before noncardiac surgery are described according to the last practical guidelines (1998). The follow up schedule after valve replacement is recommended for practical purposes.

A total of 766 valves were replaced in this period: 82, 180, 167, 135 and 202, respectively per year. There were seen these late postoperative complications: thromboembolism (3.8%), valve thrombosis (2%), hypocoagulation (1.1%) and infective endocarditis (3.2%).

Conclusion. Postoperative complications such as thromboembolism, valve thrombosis, hypocoagulation and infective endocarditis were detected more often than it is described in literature. The follow up schedule will help to identify near and late postoperative complications and to improve patients’ life quality.

Correspondence to R. Jonkaitienė, Heart Centre, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: reginajon@kmu.lt; rena_eiduk@yahoo.com

Received 14 September 2004, accepted 30 May 2005